Diagnostic and therapeutic difficulties in 32-year-old woman with stroke, patent foramen ovale and hereditary thrombophilia – case report
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Katedra i Klinika Kardiologii, Wydział Nauk o Zdrowiu w Katowicach, Śląski Uniwersytet Medyczny w Katowicach
Józefa Dąbek   

Katedra i Klinika Kardiologii, Wydział Nauk o Zdrowiu w Katowicach, Śląski Uniwersytet Medyczny w Katowicach, ul. Ziołowa 47, 40-635 Katowice, tel. +48 32 359 85 30
Ann. Acad. Med. Siles. 2016;70:250–255
Foramen ovale is a part of foetal circulation that allows blood to flow directly from the right to the left atrium. Patent foramen ovale (PFO) occurs approximately in 20% of the general population. It is suggested that PFO could be one of the possible causes of stroke, particularly if an embolic stroke is of an undetermined source. Only a minority of patients with PFO will experience stroke during their lifetime though. Because of continuous progress in diagnostics and treatment options especially, we have to deal increasingly more frequently with the necessity to choose the proper and most accurate management in this group of patients. PFO also often coexists with other predisposing factors for stroke. We described a case of a 32-year-old woman with venous stroke, initially of unknown aetiology in which thorough diagnostics revealed more than one predisposing factor for its occurrence.
Lechat P., Mas J.L., Lascault G., Loron P., Theard M., Klimczac M., Drobinski G., Thomas D., Grosgogeat Y. Prevalence of patent foramen ovale in patients with stroke. N. Engl. J. Med. 1988; 318: 1148–1152.
Hart R.G., Diener H.C., Coutts S.B., Easton J.D., Granger C.B., O’Donnell M.J., Sacco R.L., Connolly S.J. Embolic strokes of undetermined source: the case for a new clinical construct. Lancet Neurol. 2014; 13: 429–438.
Overell J.R., Bone I., Lees K.R. Interatrial septal abnormalities and stroke: a meta-analysis of case-control studies. Neurology 2000; 55: 1172–1179.
Kent D.M., Ruthazer R., Weimar C., Mas J.L., Serena J., Homma S., Di Angelantonio E., Di Tullio M.R., Lutz J.S., Elkind M.S., Griffith J., Jaigobin C., Mattle H.P., Michel P., Mono M.L., Nedeltchev K., Papetti F., Thaler D.E. An index to identify stroke-related vs incidental patent foramen ovale in cryptogenic stroke. Neurology 2013; 81: 619–625.
Furlan A.J., Reisman M., Massaro J., Mauri L., Adams H., Albers G.W., Felberg R., Herrmann H., Kar S., Landzberg M., Raizner A., Wechsler L. Closure or medical therapy for cryptogenic stroke with patent foramen ovale. N. Engl. J. Med. 2012; 366: 991–999.
Carroll J.D., Saver J.L., Thaler D.E., Smalling R.W., Berry S., MacDonald L.A., Marks D.S., Tirschwell D.L. Closure of patent foramen ovale versus medical therapy after cryptogenic stroke. N. Engl. J. Med. 2013; 368: 1092–1100.
Meier B., Kalesan B., Mattle H.P., Khattab A.A., Hildick-Smith D., Dudek D., Andersen G., Ibrahim R., Schuler G., Walton A.S., Wahl A., Windecker S., Jüni P. Percutaneous closure of patent foramen ovale in cryptogenic embolism. N. Engl. J. Med. 2013; 368: 1083–1091.
Kernan W.N., Ovbiagele B., Black H.R., Bravata D.M., Chimowitz M.I., Ezekowitz M.D., Fang M.C., Fisher M., Furie K.L., Heck D.V., Johnston S.C., Kasner S.E., Kittner S.J., Mitchell P.H., Rich M.W., Richardson D., Schwamm L.H., Wilson J.A. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2014; 45: 2160–2236.
De Stefano V., Chiusolo P., Paciaroni K., Leone G. Epidemiology of factor V Leiden: clinical implications. Semin. Thromb. Hemost. 1998; 24(4): 367–379.