An unusual case of orthodeoxia


      Progressive hypoxia in hospitalized patients can be due to many etiologies, especially in patients with multiple comorbidities. More unusual causes of hypoxia, such as patent foramen ovale (PFO) with a right to left shunting in the absence of elevated right atrial pressures, should be considered when workup does not reveal a specific etiology.
      <Learning objectives: Hypoxemia due to a right-to-left atrial shunt with normal pulmonary arterial pressures can be seen in the aortic aneurysm patients.>
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        • Layoun M.E.
        • Aboulhosn J.A.
        • Tobis J.M.
        Potential role of patent foramen ovale in exacerbating hypoxemia in chronic pulmonary disease.
        Tex Heart Inst J. Jun 2017; 44 (PMID: 28761399; PMCID: PMC5505397): 189-197
        • Maraj R.
        • Ahmed O.
        • Fraifeld M.
        • Jacobs L.E.
        • Yazdanfar S.
        • Kotler M.N.
        Hypoxia due to patent foramen ovale in the absence of pulmonary hypertension.
        Tex Heart Inst J. 1999; 26 (306-8PMID: 10653264; PMCID: PMC325672)
        • Strunk B.L.
        • Cheitlin M.D.
        • Stulbarg M.S.
        • Schiller N.B.
        Right-to-left interatrial shunting through a patent foramen ovale despite normal intracardiac pressures.
        Am J Cardiol. Aug 1987; 60 (PMID: 3618511): 413-415
        • Godart F.
        • Rey C.
        • Prat A.
        • Vincentelli A.
        • Chmaït A.
        • Francart C.
        • Porte H.
        Atrial right-to-left shunting causing severe hypoxaemia despite normal right-sided pressures. Report of 11 consecutive cases corrected by percutaneous closure.
        Eur Heart J. Mar 2000; 21 (PMID: 10681489): 483-489
        • Purvis J.A.
        • Morgan D.R.
        • Hughes S.M.
        Prevalence of patent foramen ovale in a consecutive cohort of 261 patients undergoing routine "coronary" 64-multi-detector cardiac computed tomography.
        Ulster Med J. May 2011; 80 (PMID: 22347746; PMCID: PMC3229849): 72-75