We report the case of a 39-year-old woman who presented with cryptogenic stroke. Conventional and contrast echocardiography modalities noticed a large Eustachian valve (EV) but failed to identify any right-to-left shunt. Conversely, contrast-transcranial Doppler revealed a grade 3 right-to-left shunt. Contrast echocardiography was repeated with bubble injections through both an upper extremity and a femoral vein, 10 min apart from each other. While no shunt was observed following upper extremity injection, > 20 bubbles crossed the inter-atrial septum when contrast was injected via femoral vein confirming the diagnosis of patent foramen ovale.
Boukhris, Marouane; Masson, Jean-Bernard; and Potvin, Jeannot
"Challenging Diagnosis of Patent Foramen Ovale in Presence of a Large Eustachian Valve.,"
Journal of the Saudi Heart Association: Vol. 33
, Article 4.
Available at: https://doi.org/10.37616/2212-5043.1249
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