From Mild Discomfort to Myopericarditis—A Complication of Patent Foramen Ovale Occluder Device Placement: A Case Report

TL;DR

A woman developed myopericarditis after a PFO closure device was placed, highlighting a rare complication possibly linked to nickel hypersensitivity.

Contribution

This case report identifies myopericarditis as a rare but important complication of PFO occluder devices, potentially linked to nickel hypersensitivity.

Findings

The patient developed myopericarditis after PFO closure with a GORE CARDIOFORM Septal Occluder.

Symptoms resolved with colchicine and ibuprofen, but no validated tools exist to predict nickel hypersensitivity.

Clinicians must weigh the risk of hypersensitivity against the benefits of PFO closure in stroke prevention.

Abstract

A 43-year-old woman underwent successful elective closure of a large aneurysmal patent foramen ovale (PFO) using a GORE CARDIOFORM Septal Occluder. She experienced mild chest discomfort immediately postprocedure but was discharged after a transthoracic echocardiogram confirmed appropriate device positioning and no acute abnormalities. She returned the following day with worsening pleuritic chest pain unresponsive to acetaminophen and ibuprofen. Her clinical presentation, together with her electrocardiogram, laboratory, and imaging findings, was diagnostic of myopericarditis. She was treated with colchicine and ibuprofen, resulting in complete symptom resolution. This case illustrates a rare complication of PFO closure, potentially related to nickel hypersensitivity. Currently, no validated tools exist to predict such hypersensitivity reactions, and nickel-free PFO closure devices are not commercially available. Until alternatives become available, clinicians must balance the risk of hypersensitivity reactions against the proven benefit of PFO closure in preventing recurrent stroke in select patients.

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