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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Autores principales:	Merante A, Gareri P, Castagna A, Marigliano NM, Candigliota M, Ferraro A, Ruotolo G
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	atrial septal aneurysm patent foramen ovale elderly transient cerebral ischemia percutaneous closure Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/bf4fdad5245c4e60a9f9273042523bd0
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spelling	oai:doaj.org-article:bf4fdad5245c4e60a9f9273042523bd02021-12-02T06:52:04ZTransient cerebral ischemia in an elderly patient with patent foramen ovale and atrial septal aneurysm1178-1998https://doaj.org/article/bf4fdad5245c4e60a9f9273042523bd02015-09-01T00:00:00Zhttps://www.dovepress.com/transient-cerebral-ischemia-in-an-elderly-patient-with-patent-foramen--peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Alfonso 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 closureMerante AGareri PCastagna AMarigliano NMCandigliota MFerraro ARuotolo GDove Medical Pressarticleatrial septal aneurysmpatent foramen ovaleelderlytransient cerebral ischemiapercutaneous closureGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 10, Pp 1445-1449 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	atrial septal aneurysm patent foramen ovale elderly transient cerebral ischemia percutaneous closure Geriatrics RC952-954.6
spellingShingle	atrial septal aneurysm patent foramen ovale elderly transient cerebral ischemia percutaneous closure Geriatrics RC952-954.6 Merante A Gareri P Castagna A Marigliano NM Candigliota M Ferraro A Ruotolo G Transient cerebral ischemia in an elderly patient with patent foramen ovale and atrial septal aneurysm
description	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
format	article
author	Merante A Gareri P Castagna A Marigliano NM Candigliota M Ferraro A Ruotolo G
author_facet	Merante A Gareri P Castagna A Marigliano NM Candigliota M Ferraro A Ruotolo G
author_sort	Merante A
title	Transient cerebral ischemia in an elderly patient with patent foramen ovale and atrial septal aneurysm
title_short	Transient cerebral ischemia in an elderly patient with patent foramen ovale and atrial septal aneurysm
title_full	Transient cerebral ischemia in an elderly patient with patent foramen ovale and atrial septal aneurysm
title_fullStr	Transient cerebral ischemia in an elderly patient with patent foramen ovale and atrial septal aneurysm
title_full_unstemmed	Transient cerebral ischemia in an elderly patient with patent foramen ovale and atrial septal aneurysm
title_sort	transient cerebral ischemia in an elderly patient with patent foramen ovale and atrial septal aneurysm
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/bf4fdad5245c4e60a9f9273042523bd0
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Transient cerebral ischemia in an elderly patient with patent foramen ovale and atrial septal aneurysm

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