TITLE:
Congenital Cardiac Defects, Such as Eustachian Valve, May Increase the Risk of Cryptogenic Stroke: A Case Report
AUTHORS:
Chiara Bandinelli, Giovanni Maria Puddu, Anna Balducci, Giampaolo Bianchi, Marco Zoli
KEYWORDS:
Eustachian Valve, Cryptogenic Stroke, Patent Foramen Ovale, PFO, Endocarditis, Staphylococcus aureus, Transesophageal Echocardiography, Migraine
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.10 No.6,
June
28,
2020
ABSTRACT: Eustachian valve is an embryonic endocardial heart structure; after birth it becomes an embryogenic residue and its persistance in adult life is unusual.The literature reports some cases of association between Eustachian valve and PFO and is known that the prominent Eustachian valve can represent a way facilitating systemic embolism.Several studies also investigated the role of Eustachian valve in the pathophysiology of both migraine and cerebral embolism.In addiction is known how Eustachian valve may increase the risk ofendocarditis, which mostly affects intravenous drug abusers or those withimplanted medical devices or central venous catheters. The most commonly identified organism isStaphylococcus aureus(approximately 53% of cases).We present a case of a 46-year-old woman with known migraine. She washospitalized in Stroke Unit for a cryptogenic stroke with a right-to-left shunt detected with transcranial doppler ultrasound with “bubble test” and a patentforamen ovale with right-to-left shunt with a fenestration of atrial septumand a voluminous Eustachian valve detected with transesophageal echocardiography; she developed fever with a blood cultures positive for methicillin-resis-tantStaphylococcus aureus(MRSA), even if without evidence of endocarditis vegetations.In summary,the objective of our paper is to present an exampleof a correlation between the persistence of the Eustachian valve with bothcryptogenetic stroke, possible valve infection and migraine.