Unusual cause of hypoxemia in myocardial infarction: Interventional management

Pankert, Mathieu; Cuisset, Thomas; Aldebert, Philippe; Cavaille, Guilhem; Quilici, Jacques; Lambert, Marc; Bonnet, Jacqueline

doi:10.1016/j.ijcard.2013.12.177

Cited by 2 publications

(4 citation statements)

References 7 publications

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“…Because this complication is uncommon, the physician must consider a differential diagnosis of right-toleft shunt via PFO in prolonged refractory hypoxemia cases following RV infarction, particularly if pulmonary embolism has been excluded. 2,7 Treatment focusing on optimal volume status, inotropic support, physiologic rhythm restoration, and coronary reperfusion is still the mainstay. 6 Inhaled nitric oxide was shown in two previous studies to increase cardiac function and systemic oxygenation by reducing RV preload.…”

Section: Discussionmentioning

confidence: 99%

“…Hypoxemia due to PFO is a rare complication of RV infarction. 7 Other than RV infarction, persistent right-to-left shunt via PFO has been reported in association with RV dysfunction or elevated pulmonary pressure that led to RV volume overload, including chronic obstructive pulmonary disease, tricuspid valve or pulmonary valve regurgitation, RV infarction, or recurrent pulmonary embolism. 8 9 In this patient, a PFO was identified for the first time in his life following inferior and right MI without any signs or symptoms of other causes.…”

Section: Discussionmentioning

confidence: 99%

“…Because this complication is uncommon, the physician must consider a differential diagnosis of right-to-left shunt via PFO in prolonged refractory hypoxemia cases following RV infarction, particularly if pulmonary embolism has been excluded. 2 7 …”

Section: Discussionmentioning

confidence: 99%

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Optimal Conservative Management Resolves Refractory Hypoxemia in Patient with Right Myocardial Infarction Complicated by PFO-Induced Shunting

Suryono¹,

Naesilla²,

Wulandari³

et al. 2023

Methodist DeBakey Cardiovascular Journal

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Inferior myocardial infarction is often accompanied by infarction of the right ventricle (RV). Uncommon RV infarction cases with patent foramen ovale (PFO) shunt, leading to severe persistent hypoxemia even without any pulmonary embolism involvement and often requiring invasive intervention, have been documented previously. We report a patient with RV infarction and right-to-left shunt via PFO who improved with only early revascularization and optimal standard treatment. This condition may not necessitate any invasive intervention if it is treated and monitored per standard procedures. Clinicians should consider the possibility of a right-to-left shunt in patients with RV infarction and persistent hypoxemia to implement appropriate therapeutic interventions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Optimal Conservative Management Resolves Refractory Hypoxemia in Patient with Right Myocardial Infarction Complicated by PFO-Induced Shunting

Suryono¹,

Naesilla²,

Wulandari³

et al. 2023

Methodist DeBakey Cardiovascular Journal

View full text Add to dashboard Cite

show abstract

“…Refractory hypoxemia and cardiogenic shock after an inferior ST elevation myocardial infarction with an right ventricular infarct and large PFO had significant improvement with PFO closure. 38 The 2021 ESC guidelines give a conditional recommendation (Level of evidence: C) for PFO closure when it has been shown to "unequivocally and critically contribute to the arterial desaturation and symptoms." 18…”

Section: Discussionmentioning

confidence: 99%