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The Rabbit Blood-shunt Model for the Study of Acute and Late Sequelae of Subarachnoid Hemorrhage: Technical Aspects
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Reversed shunting in CREST syndrome
Habibe Kafes1, Fatih Sen1, Sefa Unal1
1Turkiye Yuksek Ihtisas Training and Research Hospital, Department of Cardiology, Ankara, Turkey.
Journal of Clinical Ultrasound : JCU
|December 19, 2015
Summary
Patent foramen ovale (PFO) can reverse blood flow, leading to serious health issues. This defect is common and linked to severe pulmonary complications in systemic sclerosis.
Area of Science:
- Cardiology
- Pulmonology
- Rheumatology
Background:
- Patent foramen ovale (PFO) is a common congenital heart defect, usually asymptomatic due to its flap-like nature preventing significant left-to-right shunting.
- Pulmonary complications, particularly pulmonary hypertension (PAH) and interstitial lung disease, are leading causes of mortality in systemic sclerosis (SSc).
Observation:
- Pathological conditions causing cardiac rotation or elevated right atrial pressures can reverse the normal atrial pressure gradient.
- This reversal can induce a right-to-left shunt through a PFO, redirecting blood flow abnormally.
Findings:
- Systemic sclerosis-associated PAH (SSc-PAH) carries a threefold increased mortality risk compared to idiopathic PAH (IPAH).
- Diagnosis of SSc-PAH is often delayed due to insidious onset and overlapping comorbidities like cardiac, musculoskeletal, and lung parenchymal issues.
Implications:
- Understanding PFO's role in shunting is crucial for diagnosing and managing pulmonary complications in SSc.
- Early recognition and management of PFO-related shunting may improve outcomes for SSc patients with pulmonary hypertension.
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