Acute right to left shunt through patent foramen ovale presenting as hypoxemia after myocardial infarction: a case report.

Cases Journal
Tháràse FrancoPeter Schulman

Abstract

This is a report of a 56-year-old man who became hypoxic due to an acute right to left shunt after sustaining a myocardial infarction involving the right ventricle. This case provides the opportunity to review several key pathophysiologic concepts in the setting of acute right ventricular infarction. Although the development of an acute right to left shunt is a rare complication of myocardial infarction, it is important to recognize the diagnosis early in order to prevent life threatening or debilitating clinical sequelae that may result from tissue hypoxia and embolic events. Transesophageal echocardiography is the noninvasive study of choice to confirm the diagnosis. Treatment involves optimization of right ventricular function to minimize shunting. However, medical therapy may provide only temporary relief, and closure of the atrial septal defect should be considered if a clinically significant shunt persists. A 56-year-old Caucasian man with severe aortic insufficiency presented to the emergency department for evaluation of substernal chest pain. An inferior myocardial infarction was diagnosed by the electrocardiogram and serologic markers. Cardiac catheterization revealed complete occlusion of the right coronary artery as ...Continue Reading

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Citations

Nov 22, 2011·Revue des maladies respiratoires·C BancalM Bonay
Apr 25, 2018·Proceedings·Aymen AlbaghdadiAlejandro Marmol-Velez
Feb 27, 2015·Singapore Medical Journal·Mui Teng ChuaIrwani Ibrahim

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Methods Mentioned

BETA
coronary artery bypass
X-ray

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