case_images: PMC10478089_01
case_images: (A) Agitated saline contrast echocardiography showed that the maximum number of bubbles in a single frame was less than 10 bubbles (RLS 1) in three cardiac cycles after the Valsalva maneuver. (B) Two-dimensional echocardiography of the transesophageal heart showed that there was a 0.9 mm wide fissure echo in the middle ovoid fossa of the atrial septum. (C) Three-dimensional echocardiography of the Transesophageal Heart: After the Valsalva maneuver, the width of the ovoid fossa of the atrial septum was approximately 0.9 mm (star-like shunt was occasionally seen).
case_images: fpsyt-14-1229995-g001.jpg
case_images: PMC10478089_01_fpsyt-14-1229995-g001.jpg
case_images: fig1
case_images: Agitated saline contrast echocardiography was positive (RLS grade 1; Figure 1). Transesophageal echocardiography showed a fossa ovoid fissure, approximately 0.9 mm wide (occasionally stellate shunt; Figures 1B,C). When other structural abnormalities or pathological changes in the lungs and heart were ruled out, we found the patient suffered from PFO (Figure 1).
case_images: MRI T2 flare showed bilateral frontal lobe chronic small ischemic focus.
case_images: fpsyt-14-1229995-g002.jpg
case_images: PMC10478089_01_fpsyt-14-1229995-g002.jpg
case_images: fig2
case_images: Additionally, an MRI image showed bilateral frontal lobe chronic small ischemic focus (Figure 2), and MRA results were normal.