[Severe hypoxemia due to a right-left shunt at the level of the foramen ovale. A complication of right ventricular infarct].
A 76-year-old woman with an inferior wall myocardial infarction, with right ventricular involvement, developed severe arterial hypoxemia with neurological involvement. Pulmonary edema or embolism and chronic obstructive pulmonary disease were ruled-out, and a right-to-left shunt was demonstrated by contrast echocardiography at the level of the foramen ovale. After inotropic support and oxygen supplementation, the patient recovered, although with significant neurological sequelae. No focal lesions were detected in the central nervous system by computerized tomography. Hypoxemia improved, coinciding with the disappearance of right-to-left shunt by contrast echocardiography.
Barbero
J M
JM
Servicio de Cardiología, Hospital Central de la Cruz Roja, Madrid.
Ezpeleta
A I
AI
López Gil
M
M
Barroso
J L
JL
García-Cosío
F
F
D000368:Aged; D006328:Cardiac Catheterization; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006346:Heart Septum / Q000000981:diagnostic imaging; D006352:Heart Ventricles; D006801:Humans; D000860:Hypoxia / Q000000981:diagnostic imaging / Q000209:etiology*; D009203:Myocardial Infarction / Q000150:complications* / Q000000981:diagnostic imaging
Hipoxemia grave por cortocircuito derecha-izquierda a nivel del foramen oval. Una complicación del infarto de ventrículo derecho.