Posters
Academic Level (Author 1)
Resident
Academic Level (Author 2)
Resident
Discipline Track
Clinical Science
Abstract
Background: Patent Foramen Ovale (PFO) is a condition affecting about 25% of all adults. While the incidence of PFOs in pregnant women is unknown, there is an increased risk for stroke owing to major changes in hemocoagulative, hormonal, and cardiovascular parameters. Despite this, the incidence of a stroke is rare in pregnant women with a PFO. Furthermore, hemorrhagic strokes are far more common during pregnancy than ischemic strokes, as is the case here. In literature 80% of venous thromboembolisms in pregnancy are found to be associated with a DVT. In the case presented, there was no associated DVT and further hematological investigations revealed no evidence of a hypercoagulable disorder.
Case Presentation: A 28-year-old female G3P2A1, past medical history of migraines with aura presented to the emergency room with altered mental status, diplopia, and dizziness 12 days after undergoing a cesarean-section. While in the ER she lost consciousness for about 2 hours. Physical examination was difficult to perform due to mental status but there were no significant focal deficits on regaining consciousness. An MRI of the brain showed an acute right thalamic infarct. However, bilateral doppler of the lower extremities was negative for thrombosis. She was started on antiplatelet therapy and her symptoms resolved in 24 hours. A transthoracic echocardiogram with bubble study was significant for a possible PFO vs ASD and a PFO was confirmed on transesophageal echo. She was then discharged and hypercoagulation workup including extensive testing for antibodies, Protein C/S, Prothrombin gene mutations, Factor V Leiden were all negative. She then had surgical closure of the PFO and has been asymptomatic since.
Conclusions: Although pregnancy is a hypercoagulable state, incidence of strokes and coronary artery diseases need to be investigated for rarer abnormalities like PFO.
Presentation Type
Poster
Recommended Citation
Ganguly, Arup; Preciado, Hector D.; and Narmala, Shravan, "Stroke in a pregnant female with a PFO in the absence of a clot." (2024). Research Colloquium. 10.
https://scholarworks.utrgv.edu/colloquium/2023/posters/10
Included in
Stroke in a pregnant female with a PFO in the absence of a clot.
Background: Patent Foramen Ovale (PFO) is a condition affecting about 25% of all adults. While the incidence of PFOs in pregnant women is unknown, there is an increased risk for stroke owing to major changes in hemocoagulative, hormonal, and cardiovascular parameters. Despite this, the incidence of a stroke is rare in pregnant women with a PFO. Furthermore, hemorrhagic strokes are far more common during pregnancy than ischemic strokes, as is the case here. In literature 80% of venous thromboembolisms in pregnancy are found to be associated with a DVT. In the case presented, there was no associated DVT and further hematological investigations revealed no evidence of a hypercoagulable disorder.
Case Presentation: A 28-year-old female G3P2A1, past medical history of migraines with aura presented to the emergency room with altered mental status, diplopia, and dizziness 12 days after undergoing a cesarean-section. While in the ER she lost consciousness for about 2 hours. Physical examination was difficult to perform due to mental status but there were no significant focal deficits on regaining consciousness. An MRI of the brain showed an acute right thalamic infarct. However, bilateral doppler of the lower extremities was negative for thrombosis. She was started on antiplatelet therapy and her symptoms resolved in 24 hours. A transthoracic echocardiogram with bubble study was significant for a possible PFO vs ASD and a PFO was confirmed on transesophageal echo. She was then discharged and hypercoagulation workup including extensive testing for antibodies, Protein C/S, Prothrombin gene mutations, Factor V Leiden were all negative. She then had surgical closure of the PFO and has been asymptomatic since.
Conclusions: Although pregnancy is a hypercoagulable state, incidence of strokes and coronary artery diseases need to be investigated for rarer abnormalities like PFO.