Document Detail


Transient right-to-left intracardiac shunt following a right ventricular myocardial infarction.
MedLine Citation:
PMID:  23386497     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
A 56-year-old smoker presented with a 3-day history of intermittent chest pain. Cardiovascular examination on admission was normal. ECG showed minimal (<1 mm) ST elevation in lead III, and right-sided leads revealed similar mild ST-elevation. Troponin I was elevated at 10.91. He was managed as a delayed-presentation ST-elevation myocardial infarction case. 12 h following admission, he developed oxygen-resistant hypoxia and hypotension. There were no clinical or radiological signs of pulmonary congestion. CT pulmonary angiogram revealed no pulmonary embolus. A bubble-contrast echocardiogram confirmed an active interatrial right-to-left shunt without Valsalva provocation. His hypoxia steadily improved over the following 24 h and he did not require any shunt closure. A repeat bubble contrast echocardiogram showed that the shunt was now only active following a Valsalva manoeuvre. Transoesophageal echocardiography confirmed a patent foramen ovale. This is a rare but important cause of resistant hypoxia following a right-heart infarct.
Authors:
Arvindra Krishnamurthy; Hazel White; Rizwan Ahmed
Related Documents :
19909387 - Impact of tricuspid regurgitation and prior coronary bypass surgery on the geometry of ...
12939227 - Bilateral versus unilateral internal mammary revascularization in patients with diabetes.
10730737 - Torsades de pointes secondary to intravenous haloperidol after coronary bypass grafting...
10622647 - Elderly coronary artery bypass graft patients with left ventricular dysfunction are hem...
1821007 - Double outlet right ventricle with calcified rheumatic mitral stenosis.
7978407 - Deliberate hypotensive epidural anesthesia for patients with normal and low cardiac out...
Publication Detail:
Type:  Journal Article     Date:  2013-02-04
Journal Detail:
Title:  BMJ case reports     Volume:  2013     ISSN:  1757-790X     ISO Abbreviation:  BMJ Case Rep     Publication Date:  2013  
Date Detail:
Created Date:  2013-02-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101526291     Medline TA:  BMJ Case Rep     Country:  England    
Other Details:
Languages:  eng     Pagination:  -     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Chesterfield Royal Hospital, Chesterfield, UK.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

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


Previous Document:  Brainstem anaplastic glioma in patients with AIDS: a case report and review of the literature.
Next Document:  A ray of hope for a woman with Sheehan's syndrome.