• Can J Cardiol · Mar 2008

    Case Reports

    A broken heart: right-to-left shunt in the setting of normal cardiac pressures.

    • Natalie Gomperts, Robert Fowler, Eric Horlick, and Peter McLaughlin.
    • Division of Cardiology, Faculty of Medicine, University of Western Ontario, London Health Sciences Centre University Hospital.
    • Can J Cardiol. 2008 Mar 1;24(3):227-9.

    AbstractA patent foramen ovale (PFO) is a common structural cardiac variant occurring in approximately 30% of the general population. Patients are usually asymptomatic because the defect is flap-like and does not permit significant left-to-right shunting. However, pathological conditions that result in cardiac rotation or higher than normal right atrial pressures can reverse the normal left atrial to right atrial pressure gradient and cause a right-to-left shunt through a PFO. If the right-to-left shunt is persistent, systemic hypoxemia or paradoxical emboli may result. The present report describes a case of refractory hypoxemia in a critically ill patient with a PFO who had a right-to-left shunt with normal right-sided cardiac pressures.

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