A mystery featuring right-to-left shunting despite normal intracardiac pressure.
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.
Zanchetta
Mario
M
Department of Cardiovascular Disease, Cittadella General Hospital, Padua, Italy. emodinacit@ulss15.pd.it
Rigatelli
Gianluca
G
Ho
Siew Yen
SY
D006325:Heart Atria / Q000503:physiopathology*; D006344:Heart Septal Defects, Atrial / Q000503:physiopathology*; D006801:Humans; D011312:Pressure