When Sex Leads to Stroke

Biller and his team immediately pursued the possibility of a blood clot elsewhere in the patient's body that, when teamed up with a hole in the heart, might be the culprit for the cause of her stroke. Soon after, they found that the patient had a blood clot in one of the main veins in her right leg.

"Most likely what happened was that the clot that was in the venous system traveled to the heart, and because she had that hole, due to the pressure changes that occurred during intercourse, most likely the clot migrated from the right to the left chambers of her heart, and then from the left chamber of the heart and into the brain," Biller explained.

Biller prescribed the patient aspirin and a blood thinner, advised her to stop taking birth control pills on account of her present risk factors, and scheduled her for a surgery to repair the hole in her heart.

Within four days of being treated, the patient was released from the hospital with only one lingering symptom of her stroke: The facial muscles on her left side were slightly weakened.

Stroke Can Still Strike the Young

Although stroke is highly uncommon in young and otherwise healthy individuals, stroke experts stress that unidentified cardiovascular abnormalities such as this patient's hole in her heart are not as rare as many might think.

A study published in the journal Archives of Neurology in 2004 found that about one out of every four people has a hole in the heart without knowing it.

According to stroke experts, it is not too uncommon for young people with this defect -- properly known as patent foramen ovale -- to suffer a stroke during sexual intercourse, or any other activity that could introduce pressure changes in the heart.

"In some respects, to a stroke specialist there is nothing surprising about this case," said Dr. Eric Aldrich, medical director of the Stroke Service at Johns Hopkins Hospital. "Although most strokes occur in older people, and are typically due to atherosclerosis, approximately 25 percent of strokes occur in people less than 60 years old."

Although the risk of stroke in a young person is still extremely low, Aldrich added that a "classic cause of a 'young stroke' is a PFO."

"Patients with the same heart condition as this lady are at risk for stroke, and that stroke can occur any time," Lyden said.

According to Lyden, other risk factors for stroke in young people include migraine, drug use, diseases of coagulation and athletic injuries that cause a tear in the neck arteries.

Still, some stroke experts stress that even with such risk factors present in an individual the chances of a young person suffering from stroke are extremely small.

"I cannot stress enough that even with these major risk factors present, the risk of stroke in a 30-year-old woman is still very, very small," said Dr. Robert Wityk, associate professor of neurology at Johns Hopkins Hospital.

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