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Increased prevalence of migraine in adult congenital heart disease
  1. Hadewich Hermans1,
  2. Martijn C Post1,
  3. Vincent Thijs2,
  4. Marijke Spaepen3,
  5. Werner I H L Budts1
  1. 1Department of Cardiology, University Hospital Gasthuisberg, Leuven, Belgium
  2. 2Department of Neurology, University Hospital Gasthuisberg, Leuven, Belgium
  3. 3Department of General Practice, Westmeerbeek, Belgium
  1. Correspondence to:
    Dr W Budts
    Department of Cardiology, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium; werner.budts{at}uz.kuleuven.ac.be

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Right-to-left shunt might have a relationship with migraine. The transition of vasoactive substances or microemboli seems to be the most assumed link between migraine and a right-to-left shunt.1 This hypothesis is enforced by the observation that percutaneous closure of patent foramen ovale is associated with a significant decrease in prevalence or severity of migraine attacks.2 In addition, other studies focused on haemoglobin levels and showed a positive relationship between frequency of migraine attacks and rising haemoglobin levels.3 Finally, the endothelium and its interaction with the surrounding tissue and blood compounds seem to play an important role in the current trigeminovascular theory of the pathogenesis of migraine,4 and new insights on the connection between endothelial genes and migraine are emerging.

We investigated the prevalence of migraine in patients with congenital heart disease with or without an obligate right-to-left shunt. All patients >16 years with an obligate right-to-left shunt, without …

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