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Right ventricular diastolic dysfunction and patent foramen ovale causing profound cyanosis
H Shnaider1, A Shiran, A Lorber
1Department of Cardiovascular Medicine, Lady Davis Medical Center, Carmel Hospital, Haifa, Israel.
Heart (British Cardiac Society)
|May 18, 2004
Summary
A rare case of profound cyanosis in an elderly woman was caused by age-related right ventricular diastolic dysfunction and a large patent foramen ovale (PFO) causing a significant right-to-left shunt.
Area of Science:
- Cardiology
- Geriatric Medicine
- Pulmonary Hypertension
Background:
- Cyanosis in the elderly can stem from various causes, including cardiac and pulmonary issues.
- Right ventricular diastolic dysfunction (RVDD) is a condition affecting the heart's ability to relax and fill properly.
- Patent Foramen Ovale (PFO) is a congenital heart defect where a flap-like opening between the atria does not close after birth.
Observation:
- A 73-year-old woman presented with severe central cyanosis and a history of stroke.
- Cardiac morphology, pulmonary artery pressure, and coronary angiography were normal.
- A patent foramen ovale (PFO) was identified, causing a massive right-to-left shunt at the atrial level.
Findings:
- The patient exhibited normal pulmonary venous oxygen saturation and PO2 levels.
- The PFO allowed a significant right-to-left shunt, despite normal pulmonary artery pressures.
- Age-related right ventricular diastolic dysfunction was identified as the underlying cause of the shunt in this normotensive patient.
Implications:
- This case highlights a rare cause of cyanosis in the elderly due to PFO and RVDD.
- Early diagnosis and management of PFO-related shunts are crucial in preventing complications like stroke.
- Understanding age-related cardiac changes is vital for diagnosing and treating cardiovascular conditions in older adults.