PATENT FORAMEN OVALE: A CLINICAL CASE

Introduction: Patent foramen ovale (PFO) is a flaplike opening between the atrial septal primum and secundum at the location of the fossa ovalis. PFO is detected in 15% of the population. The prevalence and size is similar in males and females and declines progressively with age. Most patients are asymptomatic, while the remaining show history of stroke or transient ischemic event of undefined etiology, migraine or migraine like symptoms and neurologic decompression sickness. Our aim was to describe a clinical case of a patient with PFO, following an ischemic stroke. Clinical case: 45 year old male with personal history of aural migraines. On January 2016 he had an episode of monoparesis of the lower right limb with alteration in his walking. He was interned with an ischemic stroke diagnosis. Despite being under therapy, during the internment his neurological deficits worsen. The investigation of the embolic source revealed a PFO (all other studies returned negative). He was submitted to catheterization with percutaneous occlusion of PFO. At discharge, he was prescribed with aspirin 100 mg, clopidogrel 75 mg and simvastatin 20 mg. Results and Conclusion: When PFO is associated with an otherwise unexplained neurologic event, traditional treatment has been antiplatelet therapy alone in low-risk patients. Percutaneous closure of PFO during cardiac catheterization is a therapeutic option for patient with recurrent cryptogenic stroke due to presumed paradoxical embolism. The family doctor has a fundamental role in the continuity of the treatment for this patient, who must undergo periodic echocardiograms.