scholarly journals Patent foramen ovale revealed by COVID-19 pneumonia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Charlotte Vanhomwegen ◽  
Olivier Taton ◽  
Nicolas Selvais ◽  
Olivier Vanhove ◽  
Dimitri Leduc
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Patent Foramen Ovale ◽  
Pulmonary Ventilation ◽  
Rare Condition ◽  
Upright Position ◽  
Foramen Ovale ◽  
Intrapulmonary Shunt ◽  
Case Presentation ◽  
Refractory Hypoxemia ◽  
Interatrial Shunt

Abstract Background Platypnea-orthodeoxia syndrome (POS) is a rare condition characterized by dyspnoea (platypnea) and arterial desaturation in the upright position resolved in the supine position (orthodeoxia). Intracardiac shunt, pulmonary ventilation–perfusion mismatch and others intrapulmonary abnormalities are involved. Case presentation We report a case of POS associated with two pathophysiological issues: one, cardiac POS caused by a patent foramen ovale (PFO) and second, pulmonary POS due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) interstitial pneumonia. POS has resolved after recovery of coronavirus disease 2019 (COVID-19) pneumonia. Conclusions Right-to-left interatrial shunt and intrapulmonary shunt caused by SARS-CoV-2 pneumonia contributed to refractory hypoxemia and POS. Therefore, in case of COVID-19 patient with unexplained POS, the existence of PFO must be investigated.

Platypnoea-orthodeoxia syndrome in the elderly: A difficult-to-make diagnosis of intracardiac right-to-left shunt

2017 ◽  
Vol 62 (3) ◽  
pp. 122-125 ◽  
Author(s):  
Enrico M Zardi ◽  
Silvia Spoto ◽  
Luciana Locorriere ◽  
Giulio Cacioli ◽  
Silvia Mazzaroppi ◽  
...  
Keyword(s):  
Patent Foramen Ovale ◽  
Arteriovenous Malformations ◽  
Clinical Signs ◽  
Vascular Complications ◽  
The Elderly ◽  
Upright Position ◽  
Foramen Ovale ◽  
Case Presentation ◽  
Hepatic Diseases ◽  
Chronic Pulmonary Diseases

Introduction Platypnea-orthodeoxia syndrome is a combination of positional dyspnoea and hypoxemia; it is caused by several cardiac, pulmonary and hepatic diseases. Case presentation In this study, we describe a 77-year-old female affected by unexplained dizziness and hypoxia that exacerbated in upright position. After diagnosing platypnea-orthodeoxia syndrome and excluding all possible causes (liver cirrhosis, acute and chronic pulmonary diseases and arteriovenous malformations), the origin of the syndrome was individuated in the presence of a patent foramen ovale with right-to-left shunt. Endovascular patent foramen ovale closure permitted the resolution of symptoms and disappearance of platypnea-orthodeoxia syndrome. Conclusion Although patent foramen ovale may be present since birth without giving clinical signs, it may represent a common enough cause of platypnea-orthodeoxia syndrome and other vascular complications in the elderly.

scholarly journals Platypnea–orthodeoxia syndrome associated with COVID-19 pneumonia: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Takuo Hoshi ◽  
Yu Tadokoro ◽  
Masaru Nemoto ◽  
Junya Honda ◽  
Shihori Matsukura
Keyword(s):  
Case Report ◽  
Patent Foramen Ovale ◽  
Oxygen Therapy ◽  
Upright Position ◽  
Sitting Position ◽  
Foramen Ovale ◽  
Recumbent Position ◽  
Gradual Improvement ◽  
Case Presentation ◽  
Intracardiac Shunt

Abstract Background Platypnea–orthodeoxia syndrome (POS) is a rare clinical condition characterized by respiratory distress and/or hypoxia developing in the sitting/upright position, which is relieved in the recumbent position. This syndrome is known to have an intracardiac shunt as its primary etiology. Here, we report the case of a patient who was found to have POS without an intracardiac shunt while recovering from coronavirus disease (COVID-19) pneumonia. Case presentation A 73-year-old woman was diagnosed with severe COVID-19 pneumonia and was managed according to our institutional protocol. Although her oxygenation improved at rest, oxygen saturation dropped to lower than 80% when she was in the sitting position. She had no patent foramen ovale or other intracardiac shunts. She showed gradual improvement and was discharged under home oxygen therapy 28 days after admission. Conclusions This report highlights the importance of continuous bedside monitoring of pulse oximetry during positional changes, even if it is stable at rest, in patients with moderate to severe COVID-19.

scholarly journals Short- and long-term haemodynamic consequences of transcatheter closure of atrial septal defect and patent foramen ovale

2021 ◽  
Author(s):  
X. Jin ◽  
Y. M. Hummel ◽  
W. T. Tay ◽  
J. F. Nauta ◽  
N. S. S. Bamadhaj ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Diastolic Function ◽  
Patent Foramen Ovale ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Foramen Ovale ◽  
Short And Long Term ◽  
Interatrial Shunt ◽  
Pfo Closure

Abstract Background Transcatheter atrial septal defect (ASD) and patent foramen ovale (PFO) closure might have opposite short- and long-term haemodynamic consequences compared with restricted interatrial shunt creation, which recently emerged as a potential treatment modality for patients with heart failure with preserved ejection fraction (HFpEF). Given the opposing approaches of ASD and PFO closure versus shunt creation, we investigated the early and sustained cardiac structural and functional changes following transcatheter ASD or PFO closure. Methods In this retrospective study, adult secundum-type ASD and PFO patients with complete echocardiography examinations at baseline and at 1‑day and 1‑year follow-up who also underwent transcatheter closure between 2013 and 2017 at the University Medical Centre Groningen, the Netherlands were included. Results Thirty-nine patients (mean age 48 ± standard deviation 16 years, 61.5% women) were included. Transcatheter ASD/PFO closure resulted in an early and persistent decrease in right ventricular systolic and diastolic function. Additionally, transcatheter ASD/PFO closure resulted in an early and sustained favourable response of left ventricular (LV) systolic function, but also in deterioration of LV diastolic function with an increase in LV filling pressure (LVFP), as assessed by echocardiography. Age (β = 0.31, p = 0.009) and atrial fibrillation (AF; β = 0.24, p = 0.03) were associated with a sustained increase in LVFP after transcatheter ASD/PFO closure estimated by mean E/e’ ratio (i.e. ratio of mitral peak velocity of early filling to diastolic mitral annular velocity). In subgroup analysis, this was similar for ASD and PFO closure. Conclusion Older patients and patients with AF were predisposed to sustained increases in left-sided filling pressures resembling HFpEF following ASD or PFO closure. Consequently, these findings support the current concept that creating a restricted interatrial shunt might be beneficial, particularly in elderly HFpEF patients with AF.

Platypnoea-orthodeoxia syndrome due to a right-to-left interatrial shunt following pneumonectomy

2021 ◽  
Vol 14 (10) ◽  
pp. e245699
Author(s):  
Matthew Steward ◽  
Anthony Hall ◽  
Ross Sayers ◽  
Christopher Dickson
Keyword(s):  
Patent Foramen Ovale ◽  
Transoesophageal Echocardiography ◽  
Foramen Ovale ◽  
Success Rates ◽  
Interatrial Communication ◽  
Population Prevalence ◽  
Contrast Enhanced ◽  
High Index Of Suspicion ◽  
Interatrial Shunt

A 62-year-old man presents with breathlessness 6 months following right pneumonectomy for lung adenocarcinoma. Previous investigations had not yielded a diagnosis and his symptoms were progressing. The patient described worsened symptoms when stood up (platypnoea), with profound hypoxia until laid supine (orthodeoxia). Platypnoea-orthodeoxia syndrome due to a right-to-left interatrial shunt was diagnosed on contrast-enhanced transoesophageal echocardiography with the patient undergoing successful percutaneous patent foramen ovale closure. Patent foramen ovale is often asymptomatic with a population prevalence of around 20%–30%. Anatomical shifts postpneumonectomy can open, or worsen a previously closed interatrial communication leading to right-to-left shunting of blood. Platypnoea-orthodeoxia is under-recognised, impairing quality of life and patient outcome. Investigations can be falsely reassuring, or poorly sensitive for the causative pathology. Percutaneous closure is safe with high success rates and this case highlights the need for a high index of suspicion for shunts, particularly in postpneumonectomy patients.

scholarly journals Patent Foramen Ovale Closure for Splenic Infarction: An Unusual Presentation and an Unusual Indication

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Edgar Stroppa Lamas ◽  
Alan Vinicius Gamero Osti
Keyword(s):  
Abdominal Pain ◽  
Clinical Condition ◽  
Patent Foramen Ovale ◽  
Rare Case ◽  
Acute Abdominal Pain ◽  
Paradoxical Embolism ◽  
Splenic Infarction ◽  
Foramen Ovale ◽  
Case Presentation ◽  
Work Up

Background. Splenic infarction is a rare clinical condition. It is generally attributed to hematologic, vascular, cardioembolic, and infectious diseases or trauma. Case Presentation. We describe a rare case in an otherwise asymptomatic 41-year-old overweight woman with acute abdominal pain. Imaging work-up revealed splenic infarction. Common etiologies were excluded. A transesophageal echocardiography (TEE) revealed a patent foramen ovale (PFO). The patient was sent to closure with good outcome. Conclusion. Paradoxical embolism due to PFO can be a cause of splenic infarction, and its investigation and subsequent closure may be considered when there are no other causative disorders.

scholarly journals Prolonged Hemiplegic Migraine Associated with Irreversible Neurological Deficit and Cortical Laminar Necrosis in a Patient with Patent Foramen Ovale ：A case report

2021 ◽  
Author(s):  
Yacen Hu ◽  
Zhiqin Wang ◽  
Lin Zhou ◽  
Qiying Sun
Keyword(s):  
Neurological Deficit ◽  
Patent Foramen Ovale ◽  
Brain Mri ◽  
Foramen Ovale ◽  
Hemiplegic Migraine ◽  
Cortical Laminar Necrosis ◽  
Case Presentation ◽  
Cortical Laminar ◽  
Laminar Necrosis ◽  
Pfo Closure

Abstract Background: Aura symptoms of hemiplegic migraine (HM) usually resolve completely, permanent attack-related deficit and radiographic change are rare. Case presentation: We reported a HM case presented with progressively aggravated hemiplegic migraine episodes refractory to medication. He experienced two prolonged hemiplegic migraine attacks that led to irreversible visual impairment and cortical laminar necrosis (CLN) on brain MRI. Patent foramen ovale (PFO) was found on the patient. PFO closure resulted in a significant reduction of HM attacks. Conclusions: Prolonged hemiplegic migraine attack could result in irreversible neurological deficit with neuroimaging changes manifested as CLN. We recommend screening for PFO in patients with prolonged or intractable hemiplegic migraine, for that closure of PFO might alleviate the attacks thus preventing patient from disabling sequelae.

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