Patent Foramen Ovale in Cryptogenic Stroke: Current Understanding and Management Options

Lambert A. Wu, Joseph F. Malouf, Joseph A. Dearani, Donald J. Hagler, Guy S. Reeder, George W. Petty, Bijoy K. Khandheria

Research output: Contribution to journalReview article

99 Citations (Scopus)

Abstract

There is increasing interest in the association between patent foramen ovale (PFO) and documented stroke of unknown cause, commonly referred to as cryptogenic stroke. We reviewed the literature and, on the basis of the available data, designed a diagnostic and treatment algorithm for patients with PFO and cryptogenic stroke. Patent foramen ovale is relatively common in the general population, but its prevalence is higher in patients with cryptogenic stroke. Importantly, paradoxical embolism through a PFO should be strongly considered in young patients with cryptogenic stroke. There is no consensus on the optimal management strategy, but treatment options include antiplatelet agents, warfarin sodium, percutaneous device closure, and surgical closure. High-risk features in the patient's history (ie, temporal association between Valsalva-inducing maneuvers and stroke, coexisting hypercoagulable state, recurrent strokes, and PFO with large opening, large right-to-left shunt, or right-to-left shunting at rest, and a coexisting atrial septal aneurysm) should prompt PFO closure.

Original languageEnglish (US)
Pages (from-to)950-956
Number of pages7
JournalArchives of Internal Medicine
Volume164
Issue number9
DOIs
StatePublished - May 10 2004

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Patent Foramen Ovale
Stroke
Paradoxical Embolism
Valsalva Maneuver
Platelet Aggregation Inhibitors
Warfarin
Aneurysm
Equipment and Supplies
Therapeutics
Population

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Wu, L. A., Malouf, J. F., Dearani, J. A., Hagler, D. J., Reeder, G. S., Petty, G. W., & Khandheria, B. K. (2004). Patent Foramen Ovale in Cryptogenic Stroke: Current Understanding and Management Options. Archives of Internal Medicine, 164(9), 950-956. https://doi.org/10.1001/archinte.164.9.950

Patent Foramen Ovale in Cryptogenic Stroke : Current Understanding and Management Options. / Wu, Lambert A.; Malouf, Joseph F.; Dearani, Joseph A.; Hagler, Donald J.; Reeder, Guy S.; Petty, George W.; Khandheria, Bijoy K.

In: Archives of Internal Medicine, Vol. 164, No. 9, 10.05.2004, p. 950-956.

Research output: Contribution to journalReview article

Wu, LA, Malouf, JF, Dearani, JA, Hagler, DJ, Reeder, GS, Petty, GW & Khandheria, BK 2004, 'Patent Foramen Ovale in Cryptogenic Stroke: Current Understanding and Management Options', Archives of Internal Medicine, vol. 164, no. 9, pp. 950-956. https://doi.org/10.1001/archinte.164.9.950
Wu, Lambert A. ; Malouf, Joseph F. ; Dearani, Joseph A. ; Hagler, Donald J. ; Reeder, Guy S. ; Petty, George W. ; Khandheria, Bijoy K. / Patent Foramen Ovale in Cryptogenic Stroke : Current Understanding and Management Options. In: Archives of Internal Medicine. 2004 ; Vol. 164, No. 9. pp. 950-956.
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