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

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.