Transient cerebral ischemia in an elderly patient with patent foramen ovale and atrial septal aneurysm
Alfonso Merante,1 Pietro Gareri,2 Alberto Castagna,2 Norma Maria Marigliano,3 Mafalda Candigliota,4 Alessandro Ferraro,4 Giovanni Ruotolo1 1Geriatric Unit, “Pugliese-Ciaccio” Hospital, 2Azienda Sanitaria Provinciale (ASP), Catanzaro, 3SERT Taranto, ASL Taranto, 4Intensive Cardio...
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| Formato: | article |
| Lenguaje: | EN |
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Dove Medical Press
2015
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| Acceso en línea: | https://doaj.org/article/bf4fdad5245c4e60a9f9273042523bd0 |
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| Sumario: | Alfonso Merante,1 Pietro Gareri,2 Alberto Castagna,2 Norma Maria Marigliano,3 Mafalda Candigliota,4 Alessandro Ferraro,4 Giovanni Ruotolo1 1Geriatric Unit, “Pugliese-Ciaccio” Hospital, 2Azienda Sanitaria Provinciale (ASP), Catanzaro, 3SERT Taranto, ASL Taranto, 4Intensive Cardiology Unit, “Pugliese-Ciaccio” Hospital, Catanzaro, Italy Abstract: Cerebrovascular disease is one of the most common causes of cerebrovascular morbidity and mortality in developed countries; up to 40% of acute ischemic strokes in young adults are cryptogenic in nature – that is, no cause is determined. However, in more than half of these patients, patent foramen ovale (PFO) is seen along with an increased incidence of atrial septal aneurysm (ASA). The following is a report of an interesting case: a 68-year-old man with ASA and transient cerebral ischemia. Transesophageal echocardiography (TEE) showed the presence of ASA; a test with microbubbles derived from a mixture of air and saline or colloids pointed out a shunt on the foramen ovale following Valsalva’s maneuver. The patient underwent percutaneous transcatheter closure of the interatrial communication by an interventional cardiologist. TEE and transcranial Doppler or TEE with the microbubbles test are the recommended methods for detecting and quantifying intracardiac shunts, both at rest and following Valsalva’s maneuver. In patients following the first event of transient ischemic attack, and without clinical and anatomical risk factors (such as the presence of ASA, PFO, and basal shunt), pharmacological treatment with antiplatelets or anticoagulants is closely recommended. On the contrary, in patients following the first event of transient ischemic attack, or a recurrent event during antiplatelet treatment, the percutaneous closure of PFO is recommended. Keywords: atrial septal aneurysm, patent foramen ovale, elderly, transient cerebral ischemia, percutaneous closure |
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