Background: Patent foramen ovale and atrial septal aneurysm are among the cardiac anomalies detected by TEE that have been implicated as risk factors (potential sources of emboli) for stroke. Objective: To detect the prevalence of patent foramen ovale and atrial septal aneurysm and associated abnormalities in patients ≤ 45 years old with stroke, transient ischemic attack or retinal artery occlusion by contrast echocardiography.Subjects and methods: 43 patients with cerebrovascular events of unknown cause, were studied using transthoracic and transesophageal echocardiography, and compared to 17 normal individuals.Results: Transthoracic echocardiography using contrast was normal in 88% of the patients while 12% of the patients showed atrial septal abnormalities (patent foramen ovale in 5% and atrial septal aneurysm in 7%), whereas all of the control group were normal. Transesophageal echocardiography using contrast was normal in 58% of the patients while 42% of the patients showed atrial septal abnormalities (patent foramen ovale in 37% and atrial septal aneurysm in 21%, 16% showed combined lesions), whereas 77% of the control were normal and 33% showed atrial septal abnormalities.Conclusion: This study showed higher prevalence of atrial septal abnormalities in young patients with unexplained cerebrovascular events compared to normal individuals.