Who is suitable for PFO assessment?

  • Any young patient who has had a thromboembolic event without an obvious cause such as atherosclerosis and major CV risk factors. Specifically CVA/TIA, amourosis fugax, myocardial infarct, peripheral or any central embolic event such as mesenteric ischaemia and renal infarction.

NB: Remember Atrial Fibrillation occurs commonly in patients with atrial shunts and independently increases the thromboembolic risk.

  • Any young patient with unexplained brain MRI changes consistent with ischaemia.

  • Migraine with aura patients who you consider are:

    1. significantly debilitated

    2. experience a major lifestyle impact

    3. failure of standard medical therapy due to intolerance or a poor efficacious response

    4. Aura with hemiplegia or blindness

  • Commercial diver or any diver with migraine or previous decompression illness

  • Unexplained dyspnoea