Patent Foramen Ovale and Ischemic Stroke in Patients With Pulmonary Embolism
Authors: Preetham Kumar, M. Khalid Mojadidi, Bernhard Meier, Jonathan M. Tobis
Journal: Annals of Internal Medicine (2019)

Letters1 October 2019Patent Foramen Ovale and Ischemic Stroke in Patients With Pulmonary EmbolismPreetham Kumar, MD, M. Khalid Mojadidi, MD, Bernhard Meier, MD, and Jonathan M. Tobis, MDPreetham Kumar, MDUniversity of California, Los Angeles, Los Angeles, California (P.K., J.M.T.)Search for more papers by this author, M. Khalid Mojadidi, MDVirginia Commonwealth University, Richmond, Virginia (M.K.M.)Search for more papers by this author, Bernhard Meier, MDUniversity Hospital of Bern, Bern, Switzerland (B.M.)Search for more papers by this author, and Jonathan M. Tobis, MDUniversity of California, Los Angeles, Los Angeles, California (P.K., J.M.T.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0478 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Le Moigne and colleagues (1) assessed the frequency of patent foramen ovale (PFO) and recent ischemic stroke in patients with symptomatic pulmonary embolism. They concluded that the PFO group had a higher incidence of recent ischemic stroke than the non-PFO group. We commend the authors for their work, but the importance of appropriate PFO screening and diagnosis needs to be emphasized.According to clinical studies, the prevalence of PFO is 20% in the adult population. Different ultrasonography-based imaging methods exist for detecting right-to-left shunts, and all of them involve use of an agitated saline bubble study unless ...References1. Le Moigne E, Timsit S, Ben Salem D, et al. Patent foramen ovale and ischemic stroke in patients with pulmonary embolism. A prospective cohort study. Ann Intern Med. 2019;170:756-63. [PMID: 31060047]. doi:10.7326/M18-3485 LinkGoogle Scholar2. Mojadidi MK, Bogush N, Caceres JD, et al. Diagnostic accuracy of transesophageal echocardiogram for the detection of patent foramen ovale: a meta-analysis. Echocardiography. 2014;31:752-8. [PMID: 24372693] doi:10.1111/echo.12462 CrossrefMedlineGoogle Scholar3. Mojadidi MK, Winoker JS, Roberts SC, et al. Accuracy of conventional transthoracic echocardiography for the diagnosis of intracardiac right-to-left shunt: a meta-analysis of prospective studies. Echocardiography. 2014;31:1036-48. [PMID: 24689727] doi:10.1111/echo.12583 CrossrefMedlineGoogle Scholar4. Mojadidi MK, Gevorgyan R, Tobis JM. A comparison of methods to detect and quantitate PFO: TCD, TTE, ICE and TEE. In: Amin Z, Tobis J, Sievert H, et al, eds. Patent Foramen Ovale. London: Springer; 2015:55-65. Google Scholar5. Konstantinides S, Geibel A, Kasper W, et al. Patent foramen ovale is an important predictor of adverse outcome in patients with major pulmonary embolism. Circulation. 1998;97:1946-51. [PMID: 9609088] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of California, Los Angeles, Los Angeles, California (P.K., J.M.T.)Virginia Commonwealth University, Richmond, Virginia (M.K.M.)University Hospital of Bern, Bern, Switzerland (B.M.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0478. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPatent Foramen Ovale and Ischemic Stroke in Patients With Pulmonary Embolism Emmanuelle Le Moigne , Serge Timsit , Douraied Ben Salem , Romain Didier , Yannick Jobic , Nicolas Paleiron , Raphael Le Mao , Thierry Joseph , Clément Hoffmann , Angelina Dion , Jean Rousset , Grégoire Le Gal , Karine Lacut , Christophe Leroyer , Dominique Mottier , and Francis Couturaud Patent Foramen Ovale and Ischemic Stroke in Patients With Pulmonary Embolism Emmanuelle Le Moigne , Yannick Jobic , Serge Timsit , Clément Hoffmann , and Francis Couturaud Metrics 1 October 2019Volume 171, Issue 7Page: 527KeywordsDisclosureDoppler imagingEchocardiographyForecastingHeartIschemic strokeMortalityPulmonary embolismSpecificityStroke ePublished: 1 October 2019 Issue Published: 1 October 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...