Patent foramen ovale and cerebrovascular diseases

Desai, Amish J.; Fuller, Cindy J.; Jesurum, Jill T.; Reisman, Mark

doi:10.1038/ncpcardio0597

Cited by 40 publications

(37 citation statements)

References 64 publications

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“…Regular transthoracic echo may fail to identify most cases of PFO, and contrast-enhanced studies, transesophageal echo or transcranial Doppler imaging are more sensitive at detecting the shunt [17]. PFO is associated with interatrial septal aneurysm (IASA) in up to 56% of cases.…”

Section: Discussionmentioning

confidence: 99%

“…Several retrospective studies found a strong association of PFO and cryptogenic stroke, especially in young patients [18]. Risk factors for stroke in patients with PFO include an increase in PFO diameter, a larger magnitude of right-to-left shunt, and the presence of IASA and deep venous thromboses [17,19]. The mechanisms of stroke may include paradoxical passage of emboli through the shunt, especially after a Valsalva maneuver or in relation to increased pulmonary vascular pressure [17].…”

Section: Discussionmentioning

confidence: 99%

“…Risk factors for stroke in patients with PFO include an increase in PFO diameter, a larger magnitude of right-to-left shunt, and the presence of IASA and deep venous thromboses [17,19]. The mechanisms of stroke may include paradoxical passage of emboli through the shunt, especially after a Valsalva maneuver or in relation to increased pulmonary vascular pressure [17]. Arterial embolism of gas bubbles formed in the venous vasculature may predispose patients with PFO to severe (type II) decompression sickness.…”

Section: Discussionmentioning

confidence: 99%

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Screening Echocardiography of Military Aircrew Candidates: Aeromedical Implications

Wand¹,

Prokupetz²,

Assa³

et al. 2009

Cardiology

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Objectives: Cardiovascular evaluation has a significant aspect in the medical screening process of aircrew candidates. Echocardiography may identify asymptomatic cardiac abnormalities which can jeopardize the aviator and flight safety, as well as conditions which may progress and disqualify a trained aviator. We assessed the value of adding routine echocardiography to the aeromedical screening process. Methods: The study population consisted of 17- to 21-year-old healthy aircrew candidates. We retrospectively reviewed all routine echocardiographic studies performed during 1997–2008 at our clinic. Studies performed for a clinical indication were excluded. Results: A total of 2,657 echocardiographic studies were analyzed. 2,506 were considered ‘normal’ (94.3%). 151 studies (5.7%) demonstrated findings which required further consideration and were considered ‘abnormal’. Additional consideration included limitation to low-performance aircrafts (n = 22, 14.7%), prompt disqualification (n = 23, 15.3%), or further cardiovascular assessment (n = 106, 70% of ‘abnormal’ studies), which resulted in disqualification of 2 more candidates. Echocardiography resulted in disqualification of 0.94% of candidates, limitation to low-performance aircrafts in 0.83%, and need for follow-up in additional 1.54%. Conclusions: Echocardiographic screening affected aeromedical designation and follow-up decisions in 3.31% of candidates. Contribution of routine echocardiography is dependent on aeromedical policies. The Israeli Air Force policies regarding common findings are presented.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Screening Echocardiography of Military Aircrew Candidates: Aeromedical Implications

Wand¹,

Prokupetz²,

Assa³

et al. 2009

Cardiology

View full text Add to dashboard Cite

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“…5 The transthoracic echocardiogram involves the placement of a transducer on the patient's chest and provides information on how the blood tissue interfaces within the heart and greater vessels. Problems can occur when performing a transthoracic echocardiogram due to adipose tissue, breast tissue, and the client's unwillingness or inability to lie still during the procedure.…”

Section: Diagnosis Of Pfomentioning

confidence: 99%

Patent Foramen Ovale and Cryptogenic Stroke

Jaquis¹

2007

Dimensions of Critical Care Nursing

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Strokes are the leading cause of long-term, serious disability. A variety of identifiable risk factors exists for the development of a stroke. Individuals who had no definite and clearly identifiable cause for a stroke experience a cryptogenic stroke. The presence of a patent foramen ovale, a flaplike opening of the atrial septum between the septum primum and secundum, contributes to a 40% to 56% incidence of a cryptogenic stroke. This article reviews the pathophysiology of a patent foramen ovale, the diagnostic tests, and nurse's awareness of the potential etiology of a stroke in a younger individual.

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“…Patent foramen ovale (PFO) is a congenital heart disease characterized by an opening between the right and left atria resulting from incomplete closure of the ostium secundum by the septum secundum 1 . Recent studies have found an increase prevalence of PFO in women with migraine with aura and young adults (less than 55 years old) with so-called "cryptogenic" ischemic stroke [2][3][4][5][6] .…”

mentioning

confidence: 99%

Transcranial Doppler for patent foramen ovale screening: is there a good correlation with transesophageal echocardiography?

Lange

Zétola

Souza

et al. 2008

Arq. Neuro-Psiquiatr.

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-Right-to-left shunt (RLS) can be identified by contrast-enhanced transcranial Doppler (cTCD) in patent foramen ovale (PFO) patients. Aim: To evaluate cTCD for PFO screening comparing it to cTEE. Method: 45 previous cTCD performed for PFO diagnosis and correlated its findings with cTEE. Patients were submitted to a cTCD standardized technique and were divided in two groups according to RLS: Group 1, patients with a positive RLS and Group 2 when RLS was negative. Results: 29 (65%) patients were included in group 1 and 16 (35%) in group 2. PFO confirmation by cTEE was performed in 28 (62%) patients. cTCD had a 92.85% sensitivity, 82.35% specificity, 89.65% positive predictive value and 87.5% negative predictive value when compared to cTEE for PFO diagnosis. Conclusion: Standardized technique cTCD allows for RLS visualization in PFO patients with a good correlation with cTEE and can be used as a screening test before cTEE.KEy wORDS: patent foramen ovale, transesophageal echocardiography, transcranial Doppler, ultrasonography. Doppler transcraniano contrastado para triagem de forame oval patente: existe boa correlação com ecocardiograma transesofágico?Resumo -A comunicação direita-esquerda (CDE) pode ser identificada por Doppler transcraniano contrastado (DTCc) em pacientes com forame oval patente (FOP Patent foramen ovale (PFO) is a congenital heart disease characterized by an opening between the right and left atria resulting from incomplete closure of the ostium secundum by the septum secundum 1 . Recent studies have found an increase prevalence of PFO in women with migraine with aura and young adults (less than 55 years old) with so-called "cryptogenic" ischemic stroke [2][3][4][5][6] . Emboli from the venous system can cross the PFO reaching the arterial circulation through a right-to-left shunt (RLS) and thus leading to a stroke. PFO diagnosis is done by using a contrast-enhanced technique (by injecting saline solution in a peripheral vein) while performing a transesophageal echocardiography (cTEE) and, when positive, it shows a high correlation with necropsy studies 7 . In spite of both high sensibility and specificity, cTEE have some limitations, such as expensiveness, patient's low tolerability and imperfect intra and inter-observer correlation, due to the fact that it is an operator-dependent method 8 . A great ad-

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Patent foramen ovale and cerebrovascular diseases

Cited by 40 publications

References 64 publications

Screening Echocardiography of Military Aircrew Candidates: Aeromedical Implications

Screening Echocardiography of Military Aircrew Candidates: Aeromedical Implications

Patent Foramen Ovale and Cryptogenic Stroke

Transcranial Doppler for patent foramen ovale screening: is there a good correlation with transesophageal echocardiography?

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