title: Association of migraine aura with patent foramen ovale and atrial septal aneurysms.
abstract: BACKGROUND
  The relationship between migrainous aura and patent foramen ovale (PFO) remains uncertain
  
  
  METHODS
  We performed 'bubble' contrast transthoracic echocardiography on 80 migraineurs with 4-15 headache days per calendar month, mean age 45 (75% female) with mean 9.4 headache days. A large PFO was defined by passage of an uncountable bolus of bubbles or complete opacification of the left-heart in ≤3 cycles, while a moderate PFO was defined by passage of ≥20 bubbles but not sufficient to form a bolus or opacify the whole of the left heart.
  
  
  RESULTS
  There was a moderate or large PFO in 28 (35%; 95% CI 24-46%). There were atrial septal aneurysms in 11 (15%) and the relationship with PFO was moderately strong (spearman rank correlation 0.493, CI 0.308 to 0.643; p < 0.0001). Seven (9%) had a valve abnormality and one had a closure device for an atrial septal defect. Aura were reported in 31 (39%) and in these the PFO was large in 9 (29%) compared with 8 (16%; p = 0.143) without aura. There was no relationship between the size of the PFO and the number of headache days (difference between no PFO and large PFO = -0.6 days; 95% CI -2.6 to +1.4; p-value for any difference between groups = 0.316).
  
  
  CONCLUSIONS
  The prevalence of moderate or large patent foramen ovale was 35% and was not associated with the presence of aura or the frequency of the headache.
authors.affiliation: King's College London, London, UK; Guy's ans St Thomas' Hospitals, London, UK. Electronic address: john.chambers@gstt.nhs.uk.
authors.forename: John
authors.initials: J
authors.lastname: Chambers
authors.forename: Paul T
authors.initials: PT
authors.lastname: Seed
authors.forename: Leone
authors.initials: L
authors.lastname: Ridsdale
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D054087:Atrial Septum / Q000000981:diagnostic imaging; D005260:Female; D054092:Foramen Ovale, Patent / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D006322:Heart Aneurysm / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020325:Migraine with Aura / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D014463:Ultrasonography; D055815:Young Adult
keywords: Atrial septal aneurysm; Migraine; Patent foramen ovale