А 33-year-old man without risk factors was admitted to Cardiology Department with history of embolic stroke of unknown source (ESUS). The physical examination, laboratory tests, Holter ECG, and transthoracic echocardiography (TTE) were unremarkable. For further evaluation, he underwent transcranial contrast Doppler sonography (TCD) and transesophageal echocardiography (TEE), which showed atrial septal aneurism and patent foramen ovale (PFO) with significant right-to-left shunt. After screening for thrombophilia, the patient was scheduled for percutaneous closure of PFO. After the procedure he was discharged in a satisfactory condition with following anticoagulant therapy for a year.
Conducting further clinical testing in young patients with ESUS is important for the assessment of etiology, further treatment, and secondary stroke prevention.
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