What is a patent foramen ovale? The foramen ovale is a passageway located between the two atria that is open during fetal life when the body draws nutrients from the amniotic fluid, and closes when the fetus is born. However, in about 20% of people the foramen ovale does not close securely and at some point opens again. In the event of an unclosed foramen ovale, a percentage of patients form a blood clot in a vein, and by the time the clot reaches the left atrium, the clot travels with the blood, which leads to a stroke. “Heart-related strokes are commonly associated with atrial fibrillation, rheumatic or non-rheumatic heart valve disease, cardiomyopathy, heart block, and cardiac insufficiency, and these diseases secondary to stroke are mainly seen in middle-aged and elderly people.” Stroke secondary to heart disease in young people is seen in patients with paroxysmal atrial fibrillation, atherosclerotic lesions of the aortic arch, aortic coarctation, and patients with congenital heart disease (such as patent foramen ovale). However, because young people are strong and healthy, these primary insidious diseases are easily missed after an acute onset. In life, for young patients, routine examination of the heart is easily neglected, which is mostly related to the following factors: 1. Due to good health and strong resistance, heart problems are usually not considered after the acute onset of stroke. 2.After suffering from stroke, routine electrocardiogram examination and physical examination cannot detect small lesions of the heart, thus no further examination on the heart will be done. 3. Even if the patient goes to the primary hospital in the first instance, even if he/she considers that it may be a heart problem, he/she is often prone to miss the diagnosis due to the limitations of the examination equipment and the level of the examining physician. 4, even if the first time to the provincial and municipal hospitals, stroke patients usually do not do cardiac ultrasound, coupled with the TCD foaming test is not popular, so the potential heart disease is easy to miss the diagnosis. Therefore, we would like to remind everyone that when young people suffer from stroke, if there are no risk factors such as “three highs”, they must not forget to check their heart problems and perform relevant examinations such as transesophageal echocardiography (TEE) and TCD saline excitation test in time, so as not to miss the diagnosis of potential diseases and delay their condition.