Domenico Cartoni, Maria Penco*, Stefano De Castro, Giuliana Valente***, Corrado Costanzo***, Antonio Pelliccia****, Laura Vitali Serdoz, Rachele Adorisio**, Francesco Fedele**.
Department of Clinical Medicine, *Cardiology of University of L’Aquila, **Department of Cardiovascular and Respiratory Sciences, La Sapienza University, ***Centro Iperbarico Romano, ****Istituto di Scienza dello Sport, CONI, Rome, Italy
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An intracardiac communication between right and left circulation
may predispose subjects to an arterial shunt of blood, solid material (thrombus or fat) or gas producing
clinical features that range, respectively, from arterial desaturation, with dyspnoea and cyanosis, to
systemic ischemia via paradoxical embolism. Particularly this latter is considered a rare nosologic entity.
In fact, paradoxical embolism is usually difficult to detect during life and, according to Johnson’s criteria,
most of the cases are based on a presumptive diagnosis4.
Over the last decade, an increased number of clinical reports have detected a higher prevalence of PFO
in adult patients with unexplained acute cerebral ischemia5-8. These observations indicate that a
right-to-left intracardiac shunt may play a role in the etiology of stroke via a paradoxical embolism.
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