scholarly journals Femoral vein delivery of contrast improves transoesophageal detection of intracardiac shunting through a patent foramen ovale

Heart ◽  
2003 ◽  
Vol 89 (7) ◽  
pp. 784-784 ◽  
Author(s):  
N Halmey
Keyword(s):  
Patent Foramen Ovale ◽  
Femoral Vein ◽  
Foramen Ovale ◽  
Intracardiac Shunting

scholarly journals Platypnea-Orthodeoxia Syndrome: To Shunt or Not to Shunt, That is the Question

2016 ◽  
Vol 43 (3) ◽  
pp. 264-266 ◽  
Author(s):  
Michael R. Klein ◽  
Todd L. Kiefer ◽  
Eric J. Velazquez
Keyword(s):  
Patent Foramen Ovale ◽  
Body Position ◽  
Atrial Pressure ◽  
Right Atrial ◽  
Right Atrial Pressure ◽  
Heart Catheterization ◽  
Foramen Ovale ◽  
First Line Therapy ◽  
Saline Administration ◽  
Intracardiac Shunting

Platypnea-orthodeoxia syndrome is a rare disease defined by dyspnea and deoxygenation, induced by an upright position, and relieved by recumbency. Causes include shunting through a patent foramen ovale and pulmonary arteriovenous malformations. A 79-year-old woman experienced 2 syncopal episodes at rest and presented at another hospital. In the emergency department, she was hypoxic, needing 6 L/min of oxygen. Her chest radiograph showed nothing unusual. Transthoracic echocardiograms with saline microcavitation evaluation were mildly positive early after agitated-saline administration, suggesting intracardiac shunting. She was then transferred to our center. Right-sided heart catheterization revealed no oximetric evidence of intracardiac shunting while the patient was supine and had a low right atrial pressure. However, her oxygen saturation dropped to 78% when she sat up. Repeat transthoracic echocardiography while sitting revealed a dramatically positive early saline microcavitation-uptake into the left side of the heart. Transesophageal echocardiograms showed a patent foramen ovale, with right-to-left shunting highly dependent upon body position. The patient underwent successful percutaneous patent foramen ovale closure, and her oxygen supplementation was suspended. In patients with unexplained or transient hypoxemia in which a cardiac cause is suspected, it is important to evaluate shunting in both the recumbent and upright positions. In this syndrome, elevated right atrial pressure is not necessary for significant right-to-left shunting. Percutaneous closure, if feasible, is first-line therapy in these patients.

scholarly journals Hypoxia: An Unusual Cause with Specific Treatment

2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
John P. Berger ◽  
Ganesh Raveendran ◽  
David H. Ingbar ◽  
Maneesh Bhargava
Keyword(s):  
Pulmonary Artery ◽  
Patent Foramen Ovale ◽  
Specific Treatment ◽  
The Self ◽  
Foramen Ovale ◽  
Venous Admixture ◽  
Amplatzer Device ◽  
Diaphragmatic Weakness ◽  
Intracardiac Shunting ◽  
Predisposing Conditions

Hypoxia is a well-recognized consequence of venous admixture resulting from right to left intracardiac shunting. Right to left shunting is usually associated with high pulmonary artery pressure or alteration in the direction of blood flow due to an anatomical abnormality of the thorax. Surgical or percutaneous closure remains controversial; however it is performed frequently for patients presenting with clinical sequela presumed to be resulting from paradoxical embolization secondary to right to left shunting. We report two patients with hypoxia and dyspnea due to right to left shunting through a patent foramen ovale (PFO) and venous admixture in the absence of elevated pulmonary artery pressures or other predisposing conditions like pneumonectomy or diaphragmatic weakness. Percutaneous closures of the PFOs with the self-centering Amplatzer device resulted in resolution of hypoxia and symptoms related to it.

scholarly journals 474 Diagnosis of patent foramen ovale: femoral vein contrast administration is better

2006 ◽  
Vol 7 ◽  
pp. S72-S72
Author(s):  
U VELUPANDIAN ◽  
R KHIANI ◽  
R CALDERWOOD ◽  
J MORRIS ◽  
S RAY ◽  
...  
Keyword(s):  
Patent Foramen Ovale ◽  
Femoral Vein ◽  
Foramen Ovale ◽  
Contrast Administration

Case of positional dyspnoea and hypoxia secondary to intracardiac shunting

2021 ◽  
Vol 14 (11) ◽  
pp. e245000
Author(s):  
Vasanth Sritharan ◽  
Thomas Forshall ◽  
Vijay Joshi ◽  
Prashanth Shetty
Keyword(s):  
Outpatient Clinic ◽  
Complete Resolution ◽  
Patent Foramen Ovale ◽  
Early Recognition ◽  
Foramen Ovale ◽  
Tertiary Centre ◽  
History Of ◽  
Missed Diagnosis ◽  
Intracardiac Shunting

Platypnea-orthodexia syndrome (POS) is a rare but well-characterised condition where hypoxaemia and breathlessness occur while upright but resolve once recumbent. Early recognition can result in excellent outcomes for patients and can prevent unnecessary investigations for patients, especially if they present repeatedly to hospital after missed diagnosis. We present a case of a 75-year-old woman with a chronic history of breathlessness who was picked up after observations at a routine outpatient clinic. Early recognition of the POS allowed for appropriate investigations to take place identifying a patent foramen ovale (PFO). She was referred to the tertiary centre for closure of her PFO with complete resolution of her symptoms.

Sign in / Sign up

Export Citation Format

Share Document