As stroke rates continue to rise among young adults, one Boston man is sharing his experience of a life-threatening event at just 27 years old.
Patrick Mascoli, an engineer and fitness enthusiast, was regularly running 40 miles a week at the time of his medical emergency. Beyond a history of migraines, there were no obvious symptoms or warning signs, he shared with Fox News Digital.
On a Sunday in July 2024, Mascoli went for a 10-mile run and headed to the gym for a lifting session. As he was changing alone in the locker room, something felt suddenly wrong.
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“It just felt like a bomb went off my head,” he shared with Fox News Digital. “The right side of my brain just felt like a severe burning sensation, a lot of pain. And that came out of nowhere.”
At first, Mascoli assumed it was related to blood pressure-related fainting episodes he’d had when he was younger, but then his vision grew blurrier and the pain intensified.
“This wasn’t something I had ever experienced before,” he said.
When Mascoli tried to stand up and step forward, his leg moved to the right instead, sending him into the wall.
“No matter what I was telling my body to do, it just wasn’t working,” he said. “My legs just went in completely opposite directions of the way that I wanted them to. And my vision was a complete swirling mess.”
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Mascoli managed to text his sister before collapsing again. As his sister drove to the gym, he lay on the floor, repeatedly vomiting, unable to control his legs and struggling to see.
Stroke briefly crossed his mind, he said, but his age and fitness level made him dismiss it.
“I thought a stroke was something that happens to someone who is elderly or has other pre-existing conditions,” Mascoli said. “And in my mind, I’m like, ‘I don’t fit that.’”
When his sister arrived, she found Mascoli on the bathroom floor of the gym, drenched in sweat, and called 911.
First responders initially suspected dehydration because Mascoli was young, appeared healthy and had just run in the heat. He received IV fluids, but there was no improvement, he shared. Clinicians also treated him for suspected vertigo, but that didn’t relieve the symptoms.
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Clinicians at Boston Medical Center later identified the stroke on a CT scan and confirmed it with an MRI, according to Mascoli.
The next morning, Mascoli’s head pain had subsided, but he still had significant movement problems, particularly on his right side, which he described as “completely useless.”
He spent a few days in the hospital, during which he slowly began walking again with the use of a walker.
The diagnosis left Mascoli fearful about his future. “It was very jarring and terrifying,” he said.
Once the stroke was identified, Mascoli’s care team investigated possible causes. He underwent extensive blood testing for clotting disorders and other conditions, without clear answers.
A heart ultrasound using tiny bubbles injected into a vein revealed a patent foramen ovale (PFO) — an opening between the heart’s upper chambers that normally closes shortly after birth.
“In most people, it closes shortly after birth – but in others, it does not shut completely,” Dr. Dheeraj Khurana, chief of cardiology at Episcopal Health Services in New York, told Fox News Digital. Khurana did not treat Mascoli.
“In rare cases, a blood clot passes through this opening, travels to the brain and causes a stroke,” Khurana said.
Mascoli’s doctors considered the opening the likely route by which a clot reached his brain.
Most people with the opening experience no related health problems, according to the American Stroke Association.
In younger stroke patients who lack common risk factors and whose initial tests reveal no clear cause, doctors may look for a PFO using an ultrasound of the heart called an echocardiogram, Khurana said.
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Mascoli does have a lingering uncertainty about why a clot formed in the first place.
“I had none of the genetic predispositions to it. I had no clear physical issues that were causing it. So that is a little bit of a mystery,” he said.
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About a month after the stroke, Mascoli underwent a catheter procedure to close the opening in his heart, using an Abbott device that resembled a mesh, double-sided umbrella.
He said his cardiologist’s reassurance that the suspected pathway had been addressed helped ease his fears.
Although his mobility has improved with therapy, Mascoli said he still has lingering difficulty with fine motor skills. “I was very hard on myself, and I still get mad if my hands are shaking and my writing looks bad.”
Returning to running brought its own anxiety. Before the stroke, Mascoli said he would head out for miles without tracking his distance, but afterward, he worried about getting stranded.
“I need to know how far I’m going because I don’t want to be too far away and have something happen,” he recalled thinking.
During his recovery, Mascoli’s girlfriend gave him a fitness watch and encouraged him to start racing.
“It was something that kept me motivated, because I knew it was helping me both physically and mentally,” he said.
In October 2026, Mascoli completed the Chicago Marathon as part of Team Abbott, representing the company that made his heart implant.
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After finishing, he listened to an emotional voice message from his sister, who had helped rescue him at the gym.
“She was the one who saved me, so it meant a lot to me,” he said.
To others who have experienced health emergencies, Mascoli urged them to be patient with themselves and to not let the traumatic event define them, emphasizing that recovery looks different for everyone.
“Just take as many steps as you can,” he said. “It might not be running a marathon. It doesn’t need to be this big thing.”
Factors that may raise stroke risk in younger adults include high blood pressure, smoking, unhealthy cholesterol levels, clotting disorders, certain heart conditions and tears in the arteries supplying the brain, Khurana said.
“Younger adults with stroke may experience dizziness, altered mental status, vomiting and headaches, which they can easily mistake for exhaustion, especially after exercise or migraine,” he told Fox News Digital.
“Other common symptoms include visual disturbances, speech problems, weakness, lethargy or seizures.”
Dr. Sean Levchuck, chair of pediatric cardiology at St. Francis Hospital & Heart Center in New York, shared some general best practices for young adults to prevent a first stroke.
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“Young, active adults should stay active and exercise. Following strenuous activity, fluid replacement is necessary,” he advised.
The cardiologist also recommends avoiding smoking and tobacco products.
Anyone experiencing sudden loss of balance, vision changes, face drooping, arm weakness or difficulty speaking should call 911 immediately, regardless of age or fitness level, according to the American Stroke Association.