Abstract:
At present, the patent foramen ovale (PFO) does not receive the deserved medical attention. The PFO poses a serious threat to health and even the life of mankind. The first respective case report in the medical literature dates back to the 19th century. It led to death. The fact that a PFO is present in roughly 25% of people underscores its overall potential to cause harm. Yet at the same time, the sheer number discourages the medical community from screening for it and from treating it. About 5% of the population have particularly dangerous forms of PFOs. Such PFOs portray a high enough risk for clinical events, the likes of death, stroke, myocardial infarction, or ocular, visceral, and peripheral embolism, to justify screening for them. Highly significant health incidents being at stake, it appears obvious that PFO closure should be used for primary prevention. This is supported by the fact that closing a PFO is the simplest intervention in cardiology, with presumably the highest clinical yield. Being mainly a preventive measure, PFO closure represents a mechanical vaccination. When closing PFOs for one of the rarer therapeutic indications (migraine, platypnea orthodeoxia, etc.), patients automatically profit from the collateral benefit of getting, at the same time, mechanically vaccinated for life against paradoxical embolism. Vice versa, closing a PFO for the prevention of paradoxical embolism betters or cures migraine or exercise dyspnea not infrequently, thereby improving quality of life as a collateral benefit.
摘要:
目前,卵圆孔未闭(PFO)没有得到应有的医疗护理。PFO对人类的健康甚至生命构成严重威胁。医学文献中的第一个病例报告可以追溯到19世纪。它导致了死亡。PFO存在于大约25%的人群中,这一事实突显了其造成伤害的总体潜力。但同时,庞大的数字阻碍了医学界对其进行筛查和治疗。大约5%的人口有特别危险的PFO形式。这样的PFO描绘了足够高的临床事件风险,像死亡一样,中风,心肌梗塞,或眼睛,内脏,和外周栓塞,为他们进行筛查。高度重大的卫生事件受到威胁,很明显,PFO封堵术应该用于一级预防。这得到了以下事实的支持:关闭PFO是心脏病学中最简单的干预措施,大概是临床产量最高的。主要是一种预防措施,PFO闭合代表机械接种。当关闭PFO以获得更罕见的治疗适应症之一(偏头痛,高原呼吸直视氧,等。),患者自动从获得的附带利益中获利,同时,对矛盾的栓塞进行终身机械接种。反之亦然,关闭PFO以预防反常栓塞,改善或治愈偏头痛或运动性呼吸困难,从而提高生活质量作为附带利益。