A 37-year-old woman is sent to the emergency room after experiencing abrupt right arm weakness and trouble speaking. Although she has no relevant medical history, she uses oral contraceptives. The examination reveals a decline in right upper extremity strength as well as expressive aphasia. Cardiac auscultation is completely normal. A brain MRI demonstrates an acute infarction in the left frontal lobe. An etiology is determined by further examination. During an echocardiogram, bubbles are visible flowing into the left side of the heart after agitated normal saline is injected into a peripheral vein. Which of the following is the most likely source of this patient's observed finding?

Question

Quizplus · Accepted Answer

Eductional Objective: Approximately 25% of normal persons have a patent foramen ovale. Although the foramen ovale is generally functionally closed, brief rises in right atrial pressure above left atrial pressure can cause a right-to-left shunt, which can result in paradoxical embolism of venous clots into the arterial circulation.

A 37-Year-Old Woman Is Sent to the Emergency Room After