Patent Foramen Ovale and Inherited Thrombophilia in the Pathogenesis of Arterial Thrombosis in a Young Patient: A Case Report and Literature Review

Abstract

Background: A Patent Foramen Ovale (PFO) is frequently associated with cryptogenic stroke in young patients with paradoxical embolism as the presumed mechanism. Moreover, hypercoagulable states that are known in the pathogenesis of venous thrombosis, can sometimes be found in patients with stroke, which can be explained by the PFO, that provides the missing link. The association between PFO and prothrombotic state may hence increase the risk for paradoxical embolism. Yet, the cause-and-effect relationship between these pathologies is not clearly established and the best therapeutic and preventive strategy are unelucidated. Case Report: We report a case associating ischemic stroke, left internal carotid occlusion, and pulmonary embolism with the discovery of a PFO and inherited thrombophilic disorders, in a young woman under combined contraceptives. Conclusion: We believe that this case is important since it shows the importance of searching for a PFO in young patients with arterial events and thrombophilia and also the interest of systematic screening for procoagulant disorders in those with stroke and PFO, and highlights the challenge in the multidisciplinary management of such patients.