• Resp Care · Apr 2008

    Case Reports

    Hypoxemia secondary to right-to-left interatrial shunt through a patent foramen ovale in a patient with an elevated right hemidiaphragm.

    • Linda A Perkins, Steven M Costa, Carl D Boethel, and Mark E Lawrence.
    • Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of South Carolina, Columbia, SC 29203, USA. lperkins@gw.mp.sc.edu
    • Resp Care. 2008 Apr 1;53(4):462-5.

    AbstractThough uncommon, right-to-left shunt through a patent foramen ovale with normal right-side pressure and with a normal interatrial pressure gradient has been reported. The speculated pathophysiology is attributed to directional blood flow streaming from the vena cava to the left atrium. Hypoxemia secondary to right-to-left shunt with normal pulmonary artery pressure has been extensively documented after right pneumonectomy. Five prior cases have documented hypoxemia secondary to a right-to-left shunt through a patent foramen ovale in the presence of an elevated right hemidiaphragm. This is the sixth documented case of right-to-left shunt through a patent foramen ovale in the presence of an elevated right hemidiaphragm with a similar presentation in which closure of the patent foramen ovale resulted in resolution of hypoxemia.

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