Ischemic stroke during sexual intercourse: a report of 4 cases in persons with patent foramen ovale.
BACKGROUND
The association between patent foramen ovale (PFO) and stroke risk in young adults is controversial and poorly understood. Paradoxical embolization through a PFO represents a possible mechanism by which PFO might predispose to stroke.


OBJECTIVE
To describe 4 patients with PFO who experienced the onset of ischemic stroke during sexual intercourse.


METHODS
Case series.


METHODS
Tertiary referral stroke clinic.


METHODS
Consecutive patients experiencing stroke during intercourse.


RESULTS
All 4 patients were found to have PFO. Despite a thorough evaluation, no other etiology for stroke was identified.


CONCLUSIONS
We suggest that paradoxical embolization through a PFO due to elevated intrathoracic pressure during sexual activity could be a potential mechanism for stroke in these patients.
Becker
Kyra
K
Department of Neurology, Harborview Medical Center, University of Washington School of Medicine, 325 9th Avenue, Seattle, WA 98104-2499, USA. kjb@u.washington.edu
Skalabrin
Elaine
E
Hallam
Danial
D
Gill
Edward
E
D000328:Adult; D003075:Coitus; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008297:Male; D020521:Stroke / Q000209:etiology* / Q000503:physiopathology