Top 5 Papers (Part 1): PFO Closure or Antiplatelet Therapy for Stroke and Quantifying PE in Syncope
Each year, the Canadian Society for Internal Medicine (CSIM) Annual Meeting features a presentation of the “Top 5 Papers” in internal medicine. From the papers that had been discussed on The Rounds Table between November 2016 and October 2017, we selected 5 that we felt were particularly influential and presented them as the “Top 5 Papers” this year at CSIM. This week’s episode is the first part of the live recording of Kieran and Amol’s talk. Tune in next week for Part 2!
Firstly, we know that greater than five percent of the population has a PFO. Until now, the general consensus has been that the diagnosis of a PFO in someone who has had a stroke is essentially a red herring and does not require specific management. The first trial covered examines outcomes in patients with PFO and cryptogenic stroke randomized to either PFO closure and antiplatelet therapy or antiplatelet therapy alone.
Next, pulmonary embolism is one of those dreaded diagnoses – it can be life-threatening, but often elusive in its diagnosis since so many other conditions cause similar symptoms. Kieran and Amol take listeners through the multi-centre cross sectional PESIT study which sought to quantify the prevalence of pulmonary embolism in patients who present with syncope.
- PFO & Stroke: http://www.nejm.org/doi/full/10.1056/NEJMoa1707404
- PESIT: http://www.nejm.org/doi/full/10.1056/NEJMoa1602172#t=article
The Rounds Table Theme Music by Brendan Quinn, Creative Director and Composer, Vapor RMW