Ischemic Stroke During Sexual Intercourse: A Report of 4 Cases in Persons With Patent Foramen Ovale

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Abstract

Background

The association between patent foramen ovale (PFO) and stroke risk in young adults is controversial and poorly understood. Paradoxical embolization through a PFO represents a possible mechanism by which PFO might predispose to stroke.

Objective

To describe 4 patients with PFO who experienced the onset of ischemic stroke during sexual intercourse.

Design

Case series.

Setting

Tertiary referral stroke clinic.

Patients

Consecutive patients experiencing stroke during intercourse.

Results

All 4 patients were found to have PFO. Despite a thorough evaluation, no other etiology for stroke was identified.

Conclusion

We suggest that paradoxical embolization through a PFO due to elevated intrathoracic pressure during sexual activity could be a potential mechanism for stroke in these patients.

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