부산대학교 도서관

A patent foramen ovale (PFO) is generally present in around 25% of healthy individuals. Embolic stroke of undetermined sources (ESUS) accounts for 20% of all strokes. It has been reported that PFO is present in 50% of ESUS; thus, making the accurate diagnosis of PFO is essential for neurologists. In particular, with the approval of percutaneous closure of PFO in 2019, the diagnosis of PFO is becoming more and more important. In our hospital, the right to left shunts are examined by transcranial doppler and bedside transthoracic echocardiography and after that transesophageal echocardiography is performed. In this case, we performed transesophageal echocardiography after proving a right-left shunt by bedside echocardiography; however, PFO was not confirmed initially but became evident only in a latero-supine position. On review of the current available literature, we are unaware of similar identified cases and therefore believe that this case may be very rare and worth reporting.