title: Tricuspid regurgitation causing a right to left interatrial shunt with normal pulmonary pressures.
abstract: We describe a patient who presented with asymptomatic hypoxia refractory to supplemental oxygen. Transthoracic echocardiography and angiography demonstrated a tricuspid valve with a large regurgitant jet oriented directly at a patent foramen ovale, producing a right to left shunt with systemic hypoxia. The patient was found to have normal right-sided cardiac pressures as well as normal pulmonary arterial pressures, demonstrating the shunt was secondary to the tricuspid regurgitant jet and not a result of a pressure gradient between atria. Surgical correction of the tricuspid valve and closure of the patent foramen ovale resulted in resolution of the patient's hypoxemia.
authors.affiliation: Department of Internal Medicine, University of Illinois Medical Center, University of Illinois at Chicago, Chicago, Ill. 60612, USA.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Gans
authors.forename: John A
authors.initials: JA
authors.lastname: Kao
mesh_terms: D000328:Adult; D001794:Blood Pressure; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D000860:Hypoxia / Q000209:etiology / Q000628:therapy; D010102:Oxygen Inhalation Therapy; D011651:Pulmonary Artery / Q000502:physiology; D014262:Tricuspid Valve Insufficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014463:Ultrasonography