title: Prevalence of patent foramen ovale determined by transesophageal echocardiography in patients with cryptogenic stroke aged 55 years or older. Same as younger patients?
abstract: OBJECTIVE
  To investigate the relationship between patent foramen ovale and cryptogenic stroke in patients aged > or =55 years.
  
  
  METHODS
  This prospective study determined the presence of patent foramen ovale and atrial septal aneurysm using transesophageal echocardiography in 262 consecutive patients with a diagnosis of probable cryptogenic stroke. Data from 44 patients aged > or =55 years with cryptogenic stroke (Group A) were compared with those from two other groups: 194 patients aged <55 years with cryptogenic stroke (Group B) and 24 control patients aged > or =55 years with stroke of known origin, namely grade III-V aortic atheromatosis (Group C).
  
  
  RESULTS
  The frequency of patent foramen ovale in Group A was similar to that in Group B (38% vs. 36%; P=.85) but significantly higher than that in Group C (38% vs. 8%; P=.029). The frequency of patent foramen ovale with concomitant atrial septal aneurysm was significantly higher in the study group (Group A) than in the control Group C (18% vs. 0; P=.039) and non-significantly higher than in Group B (18% vs. 11%; P=.11).
  
  
  CONCLUSIONS
  The frequency of patent foramen ovale alone or in association with atrial septal aneurysm in patients with cryptogenic stroke aged > or =55 years was similar to that in those aged <55 years, but higher than that in patients aged > or =55 years with stroke of atherosclerotic origin. These data suggest that paradoxical embolism could be a cause of stroke in both age groups.
authors.affiliation: Servicio de Cardiologia, Hospital Universitario Reina Sofia, Cordoba, Spain. dmesar@ya.com
authors.forename: Dolores
authors.initials: D
authors.lastname: Mesa
authors.forename: Martín
authors.initials: M
authors.lastname: Ruiz
authors.forename: Mónica
authors.initials: M
authors.lastname: Delgado
authors.forename: José
authors.initials: J
authors.lastname: Suárez de Lezo
authors.forename: Manuel
authors.initials: M
authors.lastname: Pan
authors.forename: Ignacio
authors.initials: I
authors.lastname: Tejero
authors.forename: Daniel
authors.initials: D
authors.lastname: García
authors.forename: Manuel
authors.initials: M
authors.lastname: Crespín
authors.forename: Carmen
authors.initials: C
authors.lastname: León
authors.forename: Francisco
authors.initials: F
authors.lastname: Toledano
authors.forename: Francisco
authors.initials: F
authors.lastname: Mazuelos
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Ochoa
authors.forename: Enrique
authors.initials: E
authors.lastname: Bescansa
mesh_terms: D000328:Adult; D000367:Age Factors; D017548:Echocardiography, Transesophageal; D005260:Female; D054092:Foramen Ovale, Patent / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D020521:Stroke / Q000150:complications*