RSS Feeds
Searching for Patent Foramen Ovale in Patients with Stroke
- Richard D. Layne, MD
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
Include no more than 300 words of text, three authors, and five references
Type with double-spacing
Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
TO THE EDITOR:
Di Tullio and colleagues [1] found an association of cryptogenic stroke with right-to-left intracardiac shunt that was determined by contrast echocardiography and interpreted as an indication of patent foramen ovale. They concluded that when a diagnostic work-up fails to reveal a cause for the stroke, patients, regardless of age, should have contrast echocardiography. They also suggested that a normal transthoracic contrast echocardiogram might be followed by transesophageal contrast echocardiogram to exclude a patent foramen ovale.
Even without the current close examination of the nation's health care expenditures, one must question these recommendations because, as they stated, therapy for patients with ischemic stroke and patent foramen ovale remains unestablished. Indeed, the successful search for a patent foramen ovale puts the patient at risk for the costs and morbidity associated with consequent diagnostic and therapeutic measures, the utility of which is unproven. Starting down this road, then, breaks the eighth guideline for determining the clinical usefulness of a diagnostic test [2].
Until research establishes the utility of certain treatments, exhaustive searches for a patent foramen ovale cannot be considered a proven or prudent strategy.
Richard D. Layne
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
Include no more than 300 words of text, three authors, and five references
Type with double-spacing
Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright 2004 by the American College of Physicians
