Pharmacologic exposure of an occult atrial septal defect.
OBJECTIVE: To describe the diagnostic technique used to identify the presence of a symptomatic interatrial shunt obscured by normal intracardiac pressures and to discuss the unusual findings in this case and their relevance to the investigation of patients with unexplained hypoxemia. DESIGN: Case re...
| Main Authors: | , , |
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| Format: | Journal article |
| Language: | English |
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2001
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| _version_ | 1826298724444274688 |
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| author | Mackenzie, I Banning, A Dyar, O |
| author_facet | Mackenzie, I Banning, A Dyar, O |
| author_sort | Mackenzie, I |
| collection | OXFORD |
| description | OBJECTIVE: To describe the diagnostic technique used to identify the presence of a symptomatic interatrial shunt obscured by normal intracardiac pressures and to discuss the unusual findings in this case and their relevance to the investigation of patients with unexplained hypoxemia. DESIGN: Case report. SETTING: Intensive care unit of a university teaching hospital. PATIENT: A patient with a variant of the platypnea-orthodeoxia syndrome. INTERVENTIONS: Intravenous administration of metaraminol. MEASUREMENTS AND MAIN RESULTS: Clinical examination and routine investigations ruled out pneumonia or myocardial infarction as a cause of respiratory failure, and pulmonary angiography was normal other than for the demonstration of an interatrial communication. Repeated transthoracic echocardiograms failed to indicate the presence of a significant interatrial shunt that was eventually detected following temporary shunt reversal with intravenous metaraminol and confirmation by bubble-contrast transesophageal echocardiography and right heart catheter studies. CONCLUSIONS: Symptomatic right-to-left intracardiac shunt may occur in patients with normal intracardiac and pulmonary artery pressures. The presence of a significant shunt cannot be ruled out by transthoracic echocardiography without the use of bubble contrast. |
| first_indexed | 2024-03-07T04:51:11Z |
| format | Journal article |
| id | oxford-uuid:d5030032-3dac-4ca7-97c7-329e86535d62 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T04:51:11Z |
| publishDate | 2001 |
| record_format | dspace |
| spelling | oxford-uuid:d5030032-3dac-4ca7-97c7-329e86535d622022-03-27T08:22:51ZPharmacologic exposure of an occult atrial septal defect.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:d5030032-3dac-4ca7-97c7-329e86535d62EnglishSymplectic Elements at Oxford2001Mackenzie, IBanning, ADyar, OOBJECTIVE: To describe the diagnostic technique used to identify the presence of a symptomatic interatrial shunt obscured by normal intracardiac pressures and to discuss the unusual findings in this case and their relevance to the investigation of patients with unexplained hypoxemia. DESIGN: Case report. SETTING: Intensive care unit of a university teaching hospital. PATIENT: A patient with a variant of the platypnea-orthodeoxia syndrome. INTERVENTIONS: Intravenous administration of metaraminol. MEASUREMENTS AND MAIN RESULTS: Clinical examination and routine investigations ruled out pneumonia or myocardial infarction as a cause of respiratory failure, and pulmonary angiography was normal other than for the demonstration of an interatrial communication. Repeated transthoracic echocardiograms failed to indicate the presence of a significant interatrial shunt that was eventually detected following temporary shunt reversal with intravenous metaraminol and confirmation by bubble-contrast transesophageal echocardiography and right heart catheter studies. CONCLUSIONS: Symptomatic right-to-left intracardiac shunt may occur in patients with normal intracardiac and pulmonary artery pressures. The presence of a significant shunt cannot be ruled out by transthoracic echocardiography without the use of bubble contrast. |
| spellingShingle | Mackenzie, I Banning, A Dyar, O Pharmacologic exposure of an occult atrial septal defect. |
| title | Pharmacologic exposure of an occult atrial septal defect. |
| title_full | Pharmacologic exposure of an occult atrial septal defect. |
| title_fullStr | Pharmacologic exposure of an occult atrial septal defect. |
| title_full_unstemmed | Pharmacologic exposure of an occult atrial septal defect. |
| title_short | Pharmacologic exposure of an occult atrial septal defect. |
| title_sort | pharmacologic exposure of an occult atrial septal defect |
| work_keys_str_mv | AT mackenziei pharmacologicexposureofanoccultatrialseptaldefect AT banninga pharmacologicexposureofanoccultatrialseptaldefect AT dyaro pharmacologicexposureofanoccultatrialseptaldefect |