PT  - JOURNAL ARTICLE
AU  - Perkins, Linda A
AU  - Costa, Steven M
AU  - Boethel, Carl D
AU  - Lawrence, Mark E
TI  - Hypoxemia Secondary to Right-to-Left Interatrial Shunt Through a Patent Foramen Ovale in a Patient With an Elevated Right Hemidiaphragm
DP  - 2008 Apr 01
TA  - Respiratory Care
PG  - 462--465
VI  - 53
IP  - 4
4099  - http://rc.rcjournal.com/content/53/4/462.short
4100  - http://rc.rcjournal.com/content/53/4/462.full
AB  - Though uncommon, right-to-left shunt through a patent foramen ovale with normal right-side pressure and with a normal interatrial pressure gradient has been reported. The speculated pathophysiology is attributed to directional blood flow streaming from the vena cava to the left atrium. Hypoxemia secondary to right-to-left shunt with normal pulmonary artery pressure has been extensively documented after right pneumonectomy. Five prior cases have documented hypoxemia secondary to a right-to-left shunt through a patent foramen ovale in the presence of an elevated right hemidiaphragm. This is the sixth documented case of right-to-left shunt through a patent foramen ovale in the presence of an elevated right hemidiaphragm with a similar presentation in which closure of the patent foramen ovale resulted in resolution of hypoxemia.