Patent Foramen Ovale With Atrial Septal Aneurysm Is Strongly Associated With Migraine With Aura: A Large Observational Study

Roel J. R. Snijder*, Justin G. L. M. Luermans, Albert H. de Heij, Vincent Thijs, Wouter J. Schonewille, Alexander Van De Bruaene, Martin J. Swaans, Werner I. H. L. Budts, Martijn C. Post

*Corresponding author for this work

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Background-A patent foramen ovale (PFO) with atrial septal aneurysm (ASA) has been identified as a risk factor for cryptogenic stroke. Patients with migraine with aura (MA) appear to be at risk for silent brain infarction, which might be related to the presence of a PFO. However, the association between MA and PFO with ASA has never been reported. We examined this association in a large observational study. Methods and Results-Patients (> 18 years) who underwent an agitated saline transesophageal echocardiography (cTEE) at our outpatient clinics within a timeframe of 4 years were eligible to be included. Before cTEE they received a validated headache questionnaire. Two neurologists diagnosed migraine with or without aura according to the International Headache Criteria. A total of 889 patients (mean age 56.4 +/- 14.3 years, 41.7% women) were included. A PFO was present in 23.2%, an isolated ASA in 2.7%, and a PFO with ASA in 6.9%. The occurrence of migraine was 18.9%; the occurrence of MA was 8.1%. The prevalence of PFO with ASA was significantly higher in patients with MA compared to patients without migraine (18.1% vs 6.1%; OR 3.72, 95% CI 1.86-7.44, P
Original languageEnglish
Article numbere003771
JournalJournal of the American Heart Association
Issue number12
Publication statusPublished - Dec 2016


  • atrial septal aneurysm
  • cerebrovascular disorders
  • echocardiography
  • heart septal defect
  • migraine
  • patent foramen ovale

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