Document Detail

Inaccuracies of oximetry in identifying the location of intracardiac left-to-right shunts in adults.
MedLine Citation:
PMID:  18178415     Owner:  NLM     Status:  MEDLINE    
Although oximetric analysis of blood from the right heart chambers is the most commonly used method for assessing the presence of intracardiac left-to-right shunting, it sometimes provides misleading information because a patient with a left-to-right shunt in only 1 location sometimes manifests a significant oxygen step-up (1) in >1 chamber or (2) in a chamber other than that in which the shunt is actually located. This study was performed (1) to assess the frequency with which oximetric data provide such misleading results and (2) to determine which variables (if any) may contribute to the occurrence of such erroneous oximetric results. Accordingly, we analyzed oximetric data from 168 patients (61 men, 107 women, 14 to 76 years of age) with a proved left-to-right shunt at only 1 site and oximetric evidence of significant oxygen step-up. Using the criteria of Dexter et al (J Clin Invest 1947;26:554-560), Antman et al (Am J Cardiol 1980;46:265-271), or Pirwitz et al (Am Heart J 1997;133:413-417) for a significant oxygen step-up, 34%, 42%, and 35% of subjects, respectively, manifested a significant step-up in >1 chamber or a step-up only in an incorrect chamber. Compared with those with a step-up in the correct chamber only, those with a step-up in >1 chamber had larger Qp/Qs ratios (mean +/- SD, 2.7 +/- 1.2 vs 3.5 +/- 1.8, respectively, p <0.001), whereas subjects with a step-up only in an incorrect chamber had smaller Qp/Qs ratios than those with a step-up in the correct chamber (2.2 +/- 0.9 vs 2.8 +/- 1.3, respectively, p <0.001). In conclusion, in adult subjects with left-to-right intracardiac shunting in only 1 location, carefully obtained oximetric data often provide erroneous information.
Salim Ahmed; Richard A Lange; L David Hillis
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  101     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-07     Completed Date:  2008-02-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  245-7     Citation Subset:  AIM; IM    
Departments of Internal Medicine, Cardiovascular Divisions, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
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MeSH Terms
Heart Catheterization
Heart Septal Defects / blood*
Middle Aged
Predictive Value of Tests

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