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Watch Hailey Bieber’s video

What causes a stroke in older and younger patients?

Strokes are rare in patients under the age of 55, and have different causes than those in older patients.

The main causes of strokes in the 55+ category are:

  • Hardening of the arteries – atherosclerosis – with the risk factors of age, smoking, blood pressure, high cholesterol, and diabetes.
  • Atrial fibrillation with a clot coming from the heart to the brain.
  • A bleed the brain (much more rare).

In younger patients, there may be other reasons:

  • Clotting abnormalities cause by sticky blood.
  • Abnormal brain tissue that is more prone to bleeding.
  • A patent filament ovale (PFO) or a ‘hole in the heart’ although it is in facet a flap and not an actual hole.

What happened to Hailey Bieber?

In her video, Hailey describes her symptoms: drooping of the face, speech problems, and mobility issues on one side of her body.

What caused it? A PFO. And she has now undergone surgery to close it.

What does PFO closure involve?

PFO closure is a day-case procedure, where the flap is closed via a small needle puncture in the groin. A simple ‘umbrella’ device acts like a cufflink and buttons the flap closed, reducing the risk of another stroke by 50%. This is a procedure carried out frequently by myself at OneWelbeck Heart Health. Patients go home the same day with a very low complication rate.

Although some medication will be needed in the longer term, it looks like Hailey has recovered well, and her procedure has been successful.

It is worth noting that a quarter of the UK population will have a PFO; it is a variant of normal. We don’t go looking for a PFO in healthy people, and there is no evidence that closing a PFO in a healthy 25-year-old woman would do any good at all. However once you have presented with a stroke, that is a different story.

Watch Dr Malik doing a PFO closure

Dr Iqbal Malik is  Consultant Cardiologist with 20 years’ experience in PFO closure. If you’d like to see footage of him doing the procedure, watch the video below. He welcomes all patients who have suffered a stroke to see what the recovery options might be.