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A Model to Simulate Clinically Relevant Hypoxia in Humans
Published on: December 22, 2016
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Not all unexplained hypoxia is pulmonary embolism.
Mui Teng Chua1, Tiong Beng Sim, Irwani Ibrahim
1NUHS Emergency Department, National University Hospital, Emergency Medicine Department, 5 Lower Kent Ridge Road, Singapore 119074. mui_teng_chua@nuhs.edu.sg.
Singapore Medical Journal
|February 27, 2015
Summary
Right ventricular infarction can cause hypoxemia due to right-to-left shunting through a patent foramen ovale. Prompt diagnosis and intervention, including PFO closure, are crucial for managing this complication of myocardial infarction.
Area of Science:
- Cardiology
- Emergency Medicine
- Critical Care
Background:
- Acute myocardial infarction (MI) is a common emergency department presentation.
- Right ventricular infarction (RVI) occurs in up to 51% of inferior MI cases.
- RVI can lead to complex complications, including right ventricular failure.
Observation:
- A 45-year-old man with inferior MI developed refractory hypoxemia.
- The hypoxemia was attributed to right-to-left shunting via a patent foramen ovale (PFO).
- This shunt caused acute right ventricular failure.
Findings:
- Coronary angioplasty successfully treated the MI.
- Percutaneous closure of the patent foramen ovale resolved the hypoxemia.
- The patient's condition improved after combined intervention.
Implications:
- Persistent, uncorrectable hypoxemia in RVI warrants consideration of right-to-left shunting.
- Patent foramen ovale closure is a viable treatment for this specific complication.
- Early recognition and management of PFO shunting improve outcomes in RVI patients.
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