title: Hypoxemia secondary to right-to-left interatrial shunt through a patent foramen ovale in a patient with an elevated right hemidiaphragm.
abstract: Though uncommon, right-to-left shunt through a patent foramen ovale with normal right-side pressure and with a normal interatrial pressure gradient has been reported. The speculated pathophysiology is attributed to directional blood flow streaming from the vena cava to the left atrium. Hypoxemia secondary to right-to-left shunt with normal pulmonary artery pressure has been extensively documented after right pneumonectomy. Five prior cases have documented hypoxemia secondary to a right-to-left shunt through a patent foramen ovale in the presence of an elevated right hemidiaphragm. This is the sixth documented case of right-to-left shunt through a patent foramen ovale in the presence of an elevated right hemidiaphragm with a similar presentation in which closure of the patent foramen ovale resulted in resolution of hypoxemia.
authors: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of South Carolina, Columbia, SC 29203, USA. lperkins@gw.mp.sc.edu
authors: Linda A
authors: LA
authors: Perkins
authors: Steven M
authors: SM
authors: Costa
authors: Carl D
authors: CD
authors: Boethel
authors: Mark E
authors: ME
authors: Lawrence
mesh_terms: D000368:Aged; D003326:Coronary Circulation; D003964:Diaphragm / Q000002:abnormalities; D004452:Echocardiography; D005260:Female; D054092:Foramen Ovale, Patent / Q000601:surgery*; D006325:Heart Atria / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D000860:Hypoxia / Q000209:etiology*