A 38-year-old man notes abrupt loss of vision in his right visual field while reading. He has no significant medical history and reports that he neither smokes nor uses alcohol or illicit drugs. Physical examination reveals right homonymous hemianopia but no other abnormalities. Magnetic resonance imaging reveals acute left occipital infarction and normal head and neck vessels. Transesophageal echocardiography shows a patent foramen ovale without atrial septal aneurysm. What are the implications of this finding, and what therapy should be recommended?
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