Acute hypoxia due to right to left blood shunting in a patient with atrial septal defect
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Updated: Jul 16, 2026

Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
Miroslav Solar1, Jan Fridrich, Jiri Ceral
1Department of Internal Medicine, Charles University Prague, Medical Faculty Hradec Kralove, University Hospital Hradec Kralove, Sokolska 581, Hradec Kralove 500 05, Czech Republic. solarmir@seznam.cz
Abstract:
Acute right to left blood shunt is an unusual cause of acute hypoxia. We describe a case of a patient with an atrial septal defect who developed acute hypoxia due to cardiac tamponade. Acute haemopericardium developed as a complication of temporary transvenous cardiac pacing. Bubble contrast echocardiography confirmed right to left blood shunting at the atrial level. Acute hypoxaemia and the right to left blood shunt resolved when the pericardium was drained. The case underscores the importance of evaluating the presence of an intracardial shunt in patients with otherwise inexplicable hypoxia.
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