title: Refractory hypoxaemia following inferior ST-segment elevation myocardial infarction: case report of an unusual complication and review of treatment strategies.
abstract: Right ventricular (RV) infarction is not an uncommon complication of acute left ventricular infarction. It has been established that RV dysfunction post myocardial infarction (MI) is associated with increased mortality and morbidity. When RV infarction occurs in a patient with previously dormant patent foramen ovale (PFO), an unusual presentation of persistent refractory hypoxaemia ensues. We present a case of new RV infarction in a patient with underlying ischaemic cardiomyopathy, which was complicated by acute right-to-left shunting through the PFO. He was treated with percutaneous coronary intervention (PCI) and subsequent percutaneous PFO closure. We will also review the existing literature with regards to diagnostic and management strategies for patients with this unusual sequelae of MI.
authors.affiliation: Cardiac Department, National University Heart Centre, Singapore; National University Health System.
authors.forename: Weiqin
authors.initials: W
authors.lastname: Lin
authors.affiliation: Cardiac Department, National University Heart Centre, Singapore; National University Health System.
authors.forename: James Wei Luen
authors.initials: JW
authors.lastname: Yip
authors.affiliation: Cardiac Department, National University Heart Centre, Singapore; National University Health System.
authors.forename: Tiong Cheng
authors.initials: TC
authors.lastname: Yeo
mesh_terms: D054092:Foramen Ovale, Patent / Q000150:complications / Q000601:surgery; D006801:Humans; D000860:Hypoxia / Q000209:etiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000601:surgery; D062645:Percutaneous Coronary Intervention; D018487:Ventricular Dysfunction, Left / Q000209:etiology*
keywords: Acute myocardial infarction; Intra-cardiac shunt; PFO closure; Patent foramen ovale