title: Atrial septal defect associated with dilated cardiomyopathy in the setting of acute cardiac failure: importance of comprehensive bedside echocardiography in ICU.
abstract: The current report describes two patients with severe heart failure due to dilated cardiomyopathy in whom discrepancy between thermodilution cardiac output and clinical status was due to left-to-right shunt. Misdiagnosis of shunting was harmful in the early management of the first case. Secundum type atrial septal defect was confirmed by pathology in both cases. Blood samples for oxymetry should be routinely drawn during right heart catheterization for screening for intracardiac shunts. Using bedside echocardiography pulmonary-to-systemic flow ratio should also be systematically evaluated in the setting of right ventricular dilation.
authors: Centre Hospitalier Régional et Universitaire de Lille, Cardiology Hospital, Intensive care unit, Bd Pr J Leclercq, 59037 Lille Cedex, France. ennezat@yahoo.com
authors: Pierre Vladimir
authors: PV
authors: Ennezat
authors: Francis
authors: F
authors: Juthier
authors: Sylvestre
authors: S
authors: Maréchaux
authors: Frédéric
authors: F
authors: Mouquet
authors: Jean Jacques
authors: JJ
authors: Bauchart
authors: Jean Luc
authors: JL
authors: Auffray
authors: David
authors: D
authors: Montaigne
authors: Philippe
authors: P
authors: Asseman
authors: André
authors: A
authors: Vincentelli
mesh_terms: D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004452:Echocardiography; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male