Detection and Measurement of Functional Impact of Patent Foramen Ovale in case of Paradoxical Embolism

A paradoxical embolism may be the cause of a stroke in case of patent foramen ovale when other potential causes have been excluded. While transesophageal echocardiography (TEE) remains the gold standard, bed-side diagnosis for the neurologist is possible by means of transcranial echocardiography using a contrast agent that does not pass the lung. Previous studies have found the ultrasound test for right-to-left shunt (RLS) being g most sensitive when injection of contrast agent (preferable Echovist® due to higher sensitivity) is performed 5 seconds before a Valsalva maneuver. Quantification can be obtained by co…