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
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.