Physiotherapy Screening for Referral of a Patient with Patent Foramen Ovale Presenting with Neck Pain as Primary Complaint: A Case Report

Abstract

Neck pain is a common musculoskeletal disorder encountered by physiotherapists. However, it may be the early manifestation of more alarming conditions, such as cardiovascular diseases mimicking musculoskeletal pain. Patent foramen ovale (PFO) is a congenital heart defect consisting of a small opening between the right and the left atrium. A 56-year-old male presented with neck pain and head heaviness as primary complaints. The cardiovascular profile and the behavioral symptoms led the physiotherapist to find an exaggerated blood pressure response during exercise; in addition to subtle neurological signs, this prompted the physiotherapist to make an urgent referral. At the emergency department a PFO was diagnosed. To the best of the authors’ knowledge, this is the first case to describe a rare clinical presentation of a PFO presenting neck pain as primary complaint. This case report emphasizes the importance for physiotherapists to be able to triage patients for conditions outside their scope suggestive of further medical investigation.

Renal Embolism Associated with Foramen Ovale Coexisting Acute Pulmonary Embolism

“…If the foramen persists beyond the age of one [ 5 ], it is termed a patent foramen ovale (PFO). While most individuals with PFO remain asymptomatic, some may experience hypoxemia, platypnea–orthodeoxia syndrome, and neck pain [ 6 , 7 , 8 ]. A peculiar anomaly, the patent foramen ovale (PFO), facilitates a detour of pulmonary circulation by shunting the right-sided venous circulation into the left-sided arterial system [ 9 ].…”