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Abstract(s)
O Foramen Ovale Permeável é a cardiopatia congénita mais frequente, estando presente em aproximadamente 25% da população adulta em todo o mundo.
Relativamente à influência do sexo e da idade no Foramen Ovale Permeável, conclui-se que a sua frequência e tamanho são semelhantes em ambos os sexos, mas que a sua prevalência vai diminuindo progressivamente com a idade, enquanto, as suas dimensões aumentam. Quanto à prevalência de Foramen Ovale Permeável em pacientes com acidente vascular cerebral criptogénico, esta é superior comparativamente a pacientes sem este antecedente, em particular, naqueles com idade inferior a 50 anos.
Tem sido demonstrada uma associação entre o tamanho do Foramen ovale permeável e um risco superior de um primeiro acidente vascular cerebral. Para além da sua dimensão, a associação a outras alterações anatómicas, podem também aumentar o risco de ocorrência de um acidente vascular cerebral, nomeadamente o aneurisma do septo interauricular, a válvula de Eustáquio e a rede de Chiari.
A maioria dos indivíduos com Foramen Ovale Permeável, não apresentará qualquer manifestação clínica ao longo da vida, contudo, pode apresentar uma relação causa-efeito com diversas patologias, nomeadamente com o acidente vascular cerebral criptogénico, a doença da descompressão, a enxaqueca com aura e a síndrome da platipenia-ortodeoxia.
O Foramen Ovale Permeável é diagnosticado através da visualização da sua abertura e o consequente shunt direita-esquerda, sendo diagnosticado através do ecocardiograma transtorácico, o doppler transcriano e o ecocardiograma transesofágico, com injeção intravenosa de contraste, que é o exame gold-standard para o diagnóstico do Foramen Ovale Permeável.
O tratamento do Foramen Ovale Permeável consiste na prevenção secundária da sintomatologia, sendo que as terapias disponíveis são o tratamento médico (com antiagregantes plaquetários e anticoagulantes) e o encerramento da comunicação (percutâneo ou cirúrgico).
Concluindo, o Foramen Ovale Permeável é assim uma cardiopatia congénita com grande relevância clínica.
Patent Foramen Ovale is the most common congenital heart abnormality and is present in approximately 25% of the worldwide adult population. There is no sex predominance of Patent Foramen Ovale. The prevalence of detected Patent Foramen Ovale is lower in older adult patients, however, the average size is larger in older individuals. Patent Foramen Ovale is more frequent in patients with cryptogenic stroke, particularly those under age 55 years. Larger sized Patent Foramen Ovale have been shown to be associated with an increased risk of first stroke. Its association with other cardiac disorders, such as, atrial septal aneurysm, Eustachian valve and Chiari network, may also increase the risk of a stroke. Most patients with Patent Foramen Ovale remain asymptomatic throughout their lives, however, it has been linked to several conditions including cryptogenic stroke, decompression syndrome, migraine with aura and the platypnea-orthodeoxia syndrome. The direct visualization of the Patent Foramen Ovale opening and the resulting right-to-left shunting of blood are used as targets for diagnosis. The diagnostic imaging techniques most commonly used for its detection are transthoracic echocardiography, transoesophageal echocardiography and transcranial Doppler. Contrast transoesophageal echocardiography, is considered the gold standard for diagnosis. Patent Foramen Ovale treatment consists of secondary prevention of symptoms, and the available therapies are medical treatment (with antiplatelet drugs and anticoagulants) and closure of the communication (percutaneous or surgical). In conclusion, Patent Foramen Ovale is a congenital heart disease with great clinical relevance.
Patent Foramen Ovale is the most common congenital heart abnormality and is present in approximately 25% of the worldwide adult population. There is no sex predominance of Patent Foramen Ovale. The prevalence of detected Patent Foramen Ovale is lower in older adult patients, however, the average size is larger in older individuals. Patent Foramen Ovale is more frequent in patients with cryptogenic stroke, particularly those under age 55 years. Larger sized Patent Foramen Ovale have been shown to be associated with an increased risk of first stroke. Its association with other cardiac disorders, such as, atrial septal aneurysm, Eustachian valve and Chiari network, may also increase the risk of a stroke. Most patients with Patent Foramen Ovale remain asymptomatic throughout their lives, however, it has been linked to several conditions including cryptogenic stroke, decompression syndrome, migraine with aura and the platypnea-orthodeoxia syndrome. The direct visualization of the Patent Foramen Ovale opening and the resulting right-to-left shunting of blood are used as targets for diagnosis. The diagnostic imaging techniques most commonly used for its detection are transthoracic echocardiography, transoesophageal echocardiography and transcranial Doppler. Contrast transoesophageal echocardiography, is considered the gold standard for diagnosis. Patent Foramen Ovale treatment consists of secondary prevention of symptoms, and the available therapies are medical treatment (with antiplatelet drugs and anticoagulants) and closure of the communication (percutaneous or surgical). In conclusion, Patent Foramen Ovale is a congenital heart disease with great clinical relevance.
Description
Keywords
Acidente Vascular Cerebral Cardiopatia Congénita Comunicação Interauricular Foramen Ovale Permeável Terapêutica.