title: A mystery featuring right-to-left shunting despite normal intracardiac pressure.
abstract: The cause of right-to-left atrial shunting despite normal intracardiac pressures and normal or near-normal pulmonary function through a patent foramen ovale has still not been completely clarified. It is probably responsible for several linked diseases, such as paradoxical embolism, platypnea-orthodeoxia syndrome, migraine with aura, transient global amnesia, and decompression sickness in sport divers. Despite modern diagnostic methods, the underlying anatomophysiologic and pathogenic mechanisms of right-to-left atrial shunting without abnormal intracardiac pressures remain a matter of debate and controversy. Holistically speaking, a return to a direct study of embryology, gross anatomy, and physiology may help us elucidate the real mechanism of this paradoxical shunting.
authors.affiliation: Department of Cardiovascular Disease, Cittadella General Hospital, Padua, Italy. emodinacit@ulss15.pd.it
authors.forename: Mario
authors.initials: M
authors.lastname: Zanchetta
authors.forename: Gianluca
authors.initials: G
authors.lastname: Rigatelli
authors.forename: Siew Yen
authors.initials: SY
authors.lastname: Ho
mesh_terms: D006325:Heart Atria / Q000503:physiopathology*; D006344:Heart Septal Defects, Atrial / Q000503:physiopathology*; D006801:Humans; D011312:Pressure