Embolic stroke and patent foramen ovale in a 43-year-old fan chanting during a football match

On examination the patient was generally fit and well; his pulse was 92 beats per min, blood pressure was 140/90 mm Hg, and his oxygen saturation was 94%. MRI showed a small acute embolic ischaemic lesion in the postcentral gyrus of the right hemisphere (figure 1); doppler and duplex sonography of extracranial and intracranial vessels and multimodal imaging—including magnetic resonance angiography—ruled out any atherosclerotic plaques, dissection, or vasculitis (figure 1). Transoesophageal echocardiography showed a patent foramen ovale (PFO) with spontaneous passage of bubbles and accentuation with Valsalva manoeuvre; no septal aneurysm was seen (figure 2).