{
  "abstract": "Background Patent foramen ovale (PFO) is implicated in cryptogenic stroke, and bubble echocardiography (BE) is widely used for its detection. The clinical utility of BE in patients with stroke and transient ischaemic attack (TIA), particularly in relation to risk stratification and RoPE score, remains an area of ongoing evaluation.Methods We performed a retrospective analysis of patients undergoing BE between June 2024 and August 2025 at a single centre in Wales. Inclusion was limited to patients referred by the stroke service with an indication of ischaemic stroke or TIA. Demographics, vascular risk factors, stroke subtype, BE findings, and Risk of Paradoxical Embolism (RoPE) scores were analysed.Results 76 patients (mean age 51; 63% male) underwent BE: 88% for stroke and 12% for TIA. Vascular risk factors were common (39% cardiovascular disease, 14% diabetes/pre-diabetes, 36% smoking history, 47% hyperlipidaemia).PFO was identified in 38 patients (50%), with similar prevalence in TIA (44%) and stroke (51%) cohorts. Higher RoPE scores (up to 8) were associated with grade III PFO and large territorial infarcts, whereas lower scores were linked to smaller shunts and TIA presentations.Conclusion BE demonstrates high diagnostic yield in cryptogenic cerebrovascular events and should be considered in both stroke and TIA pathways. Combining BE findings with RoPE score identifies a high-risk phenotype of large infarct, high-grade shunt, high RoPE, who most likely to benefit from closure. These findings align with randomised data from RESPECT and CLOSE trials and European Society of Cardiology recommendations, supporting an imaging-guided approach to secondary stroke prevention. In patients with cryptogenic stroke/TIA, which combination of findings best identifies those most likely to benefit from PFO closure?A. Small infarct, low-grade shunt, low RoPE scoreB. Large infarct, high-grade shunt, high RoPE scoreC. Large infarct, low-grade shunt, low RoPE scoreD. Small infarct, high-grade shunt, low RoPE scoreE. No infarct (TIA), low-grade shunt, low RoPE scoreCorrect answer: B",
  "authors": [
    {
      "affiliations": [
        "Wrexham Maelor Hospital, BetsiCadwaladr University Health Board"
      ],
      "name": "Megan Jenkins"
    },
    {
      "affiliations": [
        "Wrexham Maelor Hospital, BetsiCadwaladr University Health Board"
      ],
      "name": "Dylan Mehew"
    },
    {
      "affiliations": [
        "Wrexham Maelor Hospital, BetsiCadwaladr University Health Board"
      ],
      "name": "Irfan Rind"
    }
  ],
  "title": "28 Utility of bubble echocardiography in patients with cryptogenic stroke and transient ischaemic attack: a single-centre experience",
  "uid": "05610978-2d74-5350-b0d2-eca4eeca5e94"
}