Aging and patent foramen ovale

The clinical syndromes associated with patent foramen ovale (PFO), have traditionally been studied in populations of young adults. The initial reports linking thromboembolic stroke to PFO [1, 2] included only stroke patients <55 years of age, based on an assumption that older patients would have a greater prevalence of traditional stroke risk factors. The three published prospective randomized PFO/Stroke trials [35] were limited to patients <60 years of age, again in an attempt to minimize the impact of coinciding traditional risk factors as potential stroke sources. As the relationship between PFO and migraine headache came into focus, it was again centered on a younger population as most migraineurs are women, and most have a significant reduction, or elimination, of migraine symptoms after the onset of menopause [6]. As a result, through the history of the PFO literature, there has been little discussion on the clinical impact of PFO in an aging population.