Right hemidiaphragmatic elevation with a right-to-left interatrial shunt through a patent foramen ovale: a case report and literature review

Chest. 2001 Dec;120(6):2094-6. doi: 10.1378/chest.120.6.2094.

Abstract

A right-to-left shunt (RLS) is an uncommon complication of a patent foramen ovale (PFO) that may cause hypoxemia from venous admixture and ischemic complications from paradoxic embolization. This report presents the third described patient whose RLS through a PFO and profound hypoxemia developed in association with right hemidiaphragm dysfunction (but without a pressure gradient driving the right-to-left flow). In addition to extending the available experience with this unusual clinical event, we report on the successful closure of the PFO by a catheter-deployed double-umbrella device, after the positioning of which the patient's oxygenation normalized.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Cardiac Catheterization
  • Diagnosis, Differential
  • Diaphragm / physiopathology
  • Embolism, Paradoxical / etiology
  • Embolism, Paradoxical / physiopathology
  • Embolism, Paradoxical / surgery
  • Female
  • Heart Atria / surgery
  • Heart Septal Defects, Atrial / complications*
  • Heart Septal Defects, Atrial / physiopathology
  • Heart Septal Defects, Atrial / surgery
  • Heart Septum / surgery
  • Humans
  • Hypoxia / etiology*
  • Hypoxia / physiopathology
  • Hypoxia / surgery
  • Prostheses and Implants
  • Pulmonary Atelectasis / etiology*
  • Pulmonary Atelectasis / physiopathology
  • Pulmonary Atelectasis / surgery
  • Respiratory Paralysis / etiology*
  • Respiratory Paralysis / physiopathology
  • Respiratory Paralysis / surgery