Document Detail

Atrial septal aneurysm with right-to-left interatrial shunting.
MedLine Citation:
PMID:  12638676     Owner:  NLM     Status:  MEDLINE    
Interatrial shunting in the presence of an atrial septal aneurysm is an uncommon but well recognized abnormality. Previous case reports have demonstrated that elevated right atrial pressure secondary to pulmonary embolism or right ventricular infarction may cause right-to-left interatrial shunting in the presence of an atrial septal aneurysm. We describe a unique situation in which an atrial septal aneurysm was associated with a right-to-left shunt secondary to severe systemic hypotension and normal right atrial pressure. In this patient, we used midodrine, an oral alpha-1 agonist, to increase systemic arterial pressure, decrease the severity of the shunt, and treat the severe hypoxemia. This case establishes that right-to-left interatrial shunting can result from a decrease in left ventricular afterload with normal right atrial pressure. Oral alpha-1 agonist therapy can be used successfully to treat patients such as ours and possibly others with similar functional abnormalities.
Mala Chidambaram; Steven Mink; Sat Sharma
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital     Volume:  30     ISSN:  0730-2347     ISO Abbreviation:  Tex Heart Inst J     Publication Date:  2003  
Date Detail:
Created Date:  2003-03-17     Completed Date:  2003-06-11     Revised Date:  2013-04-18    
Medline Journal Info:
Nlm Unique ID:  8214622     Medline TA:  Tex Heart Inst J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  68-70     Citation Subset:  IM    
Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada R2H 2A6.
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MeSH Terms
Adrenergic alpha-Agonists / therapeutic use*
Fistula / diagnosis,  drug therapy*,  etiology*
Heart Aneurysm / complications*,  diagnosis,  drug therapy*
Heart Atria / drug effects*
Heart Septum / drug effects*
Midodrine / therapeutic use*
Reg. No./Substance:
0/Adrenergic alpha-Agonists; 42794-76-3/Midodrine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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