“…We read with interest the article by Salari et al on a 34‐year‐old male with mitochondrial encephalopathy, lactic acidosis, and stroke‐like episode (MELAS) syndrome who had reportedly suffered from recurrent, ischemic, cardioembolic strokes. 1 The patient presented phenotypically with cognitive decline, epilepsy, “stroke,” myopathy, and lactic acidosis. 1 During the clarification of the ischemic strokes, a patent foramen ovale (PFO) and thrombi in the left atrial appendage (LAA) were found.…”