• John Chambers, Paul T Seed, and Leone Ridsdale.
• King's College London, London, UK; Guy's ans St Thomas' Hospitals, London, UK. Electronic address: john.chambers@gstt.nhs.uk.
• Int. J. Cardiol. 2013 Oct 9; 168 (4): 3949-53.

BackgroundThe relationship between migrainous aura and patent foramen ovale (PFO) remains uncertainMethodsWe performed 'bubble' contrast transthoracic echocardiography on 80 migraineurs with 4-15 headache days per calendar month, mean age 45 (75% female) with mean 9.4 headache days. A large PFO was defined by passage of an uncountable bolus of bubbles or complete opacification of the left-heart in ≤3 cycles, while a moderate PFO was defined by passage of ≥20 bubbles but not sufficient to form a bolus or opacify the whole of the left heart.ResultsThere was a moderate or large PFO in 28 (35%; 95% CI 24-46%). There were atrial septal aneurysms in 11 (15%) and the relationship with PFO was moderately strong (spearman rank correlation 0.493, CI 0.308 to 0.643; p < 0.0001). Seven (9%) had a valve abnormality and one had a closure device for an atrial septal defect. Aura were reported in 31 (39%) and in these the PFO was large in 9 (29%) compared with 8 (16%; p = 0.143) without aura. There was no relationship between the size of the PFO and the number of headache days (difference between no PFO and large PFO = -0.6 days; 95% CI -2.6 to +1.4; p-value for any difference between groups = 0.316).ConclusionsThe prevalence of moderate or large patent foramen ovale was 35% and was not associated with the presence of aura or the frequency of the headache.© 2013.

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