Kent et al reported the Risk of Paradoxical Embolism (RoPE) for a patient with cryptogenic stroke. This can help to identify a patient who may have a patent foramen ovale. The authors are from multiple hospitals in the United States, Canada and Europe.
Patient selection: cryptogenic stroke, age >= 18 years
Parameter:
(1) age in years
(2) cortical infarct on imaging
(3) history of hypertension
(4) history of diabetes
(5) history of stroke or transient ischemic attack (TIA)
(6) smoker
|
Parameter |
Finding |
Points |
|
age in years |
18 to 29 years |
5 |
|
|
30 to 39 years |
4 |
|
|
40 to 49 years |
3 |
|
|
50 to 59 years |
2 |
|
|
60 to 69 years |
1 |
|
|
>= 70 years |
0 |
|
cortical infarct |
no |
0 |
|
|
yes |
1 |
|
history of hypertension |
no |
1 |
|
|
yes |
1 |
|
history of diabetes |
no |
1 |
|
|
yes |
0 |
|
history of stroke or TIA |
no |
1 |
|
|
yes |
0 |
|
smoker |
no |
1 |
|
|
yes |
0 |
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The higher the score the more likely that the patient has a patent foramen ovale.
|
Parameter |
Patent Foramen Ovale |
|
<= 3 |
23% |
|
4 or 5 |
35% |
|
6 |
47% |
|
7 |
54% |
|
8 |
67% |
|
9 or 10 |
73% |
Purpose: To evaluate an adult with cryptogenic stroke using the Risk of Paradoxical Embolism (RoPE) score of Kent et al.
Specialty: Neurology
Objective: risk factors, complications
ICD-10: I60, I61, I62, I63, I64,
