An Unusual Case of Hypoxia: A Case of Right-to-Left Interatrial Shunting in a Patient With a Patent Foramen Ovale and Normal Pulmonary Pressure.

Content Provider	Europe PMC
Author	Abdelsayed, Nardine Duff, Richard Faris, Mohamed
Editor	Muacevic, Alexander Adler, John R
Copyright Year	2022
Abstract	A patent foramen ovale (PFO) is an embryological remnant. Hypoxia in the setting of a PFO is generally attributed to pulmonary hypertension resulting in an increase in right atrial pressure and mixing of venous blood from the right atrium with blood in the left atrium resulting in a right-to-left interatrial shunt (RLIAS), thus deoxygenating it. We present a case of a 64-year-old male with a past medical history of coronary artery disease (CAD) who presented with two weeks of dyspnea on exertion and intermittent chest pressure. He was found to be hypoxic at 87% (normal >95%) with largely normal workup except for left anterior descending (LAD) stenosis, which was stented, and a PFO that was found on transesophageal echocardiogram with normal pulmonary artery pressure (PAP). This case of hypoxia in the setting of a PFO without pulmonary hypertension puts into question the pathophysiology of hypoxia in a PFO and RLIAS.
Journal	Cureus
Volume Number	14
DOI	10.7759/cureus.22998
PubMed Central reference number	PMC8993988
Issue Number	3
PubMed reference number	35415050
e-ISSN	21688184
Language	English
Publisher	Cureus
Publisher Date	2022-03-09
Publisher Place	Palo Alto (CA)
Access Restriction	Open
Subject Keyword	left heart cath right heart cath transthoracic echocardiogram echocardiogram right to left atrioventricular shunt hypoxia patent foramen ovale
Content Type	Text
Resource Type	Case study
Subject	Medicine