title: Ischemic stroke occurring during intercourse in young women on oral contraceptives.
abstract: Ischemic stroke occurring during intercourse in young patients is exceedingly rare. We present 2 cases of young women taking oral contraceptives, each presenting with an ischemic stroke. Transthoracic echocardiography revealed a patent foramen ovale in one patient and an atrial septal defect in the other. The most likely cause of stroke in both patients is embolic. Despite conflicting evidence, young patients presenting with ischemic stroke and found to have a patent foramen ovale or atrial septal defect should be considered for possible device-based closure.
authors.affiliation: Osler Medical Service, Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland. Electronic address: Elliottmiller@jhmi.edu.
authors.forename: P Elliott
authors.initials: PE
authors.lastname: Miller
authors.affiliation: Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Lorrel
authors.initials: L
authors.lastname: Brown
authors.affiliation: Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Paras
authors.initials: P
authors.lastname: Khandheria
authors.affiliation: Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Jon R
authors.initials: JR
authors.lastname: Resar
mesh_terms: D000328:Adult; D002545:Brain Ischemia / Q000175:diagnosis / Q000209:etiology*; D002533:Cerebral Angiography; D003075:Coitus; D003276:Contraceptives, Oral / Q000009:adverse effects*; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D017548:Echocardiography, Transesophageal; D005260:Female; D054092:Foramen Ovale, Patent / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D006344:Heart Septal Defects, Atrial / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D016276:Ventricular Function
chemical_list: D003276:Contraceptives, Oral