Offenes Foramen ovale und Platypnoe nach Pneumonektomie
| Autor: | V Grimm, D L Heene, Werner Jaschke, J Buss, Huck K |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Artificial ventilation
medicine.medical_specialty Heart septal defect business.industry Right-to-left shunt medicine.medical_treatment General Medicine medicine.disease Inferior vena cava Pneumonectomy medicine.vein medicine.artery Internal medicine cardiovascular system medicine Cardiology Patent foramen ovale medicine.symptom business Platypnea Shunt (electrical) |
| Zdroj: | DMW - Deutsche Medizinische Wochenschrift. 117:1874-1880 |
| ISSN: | 1439-4413 0012-0472 |
| DOI: | 10.1055/s-2008-1062523 |
| Popis: | Six months after a pneumonectomy for myeloma, which had preoperatively been indistinguishable from bronchial carcinoma, a 50-year-old man presented with shortage of breath, cyanosis and episodes of syncope on standing or walking, symptoms which improved on lying down (platypnea). On one occasion these symptoms necessitated controlled artificial ventilation, but even at an inspiratory oxygen saturation of 100%, blood gases only partially improved (pCO2 27 mm Hg, pO2 67 mm Hg, O2 saturation 93%). Right heart catheterization in recumbency revealed a right to left shunt at atrial level of 37% of systemic flow. Contrast medium injection into the inferior vena cava near the heart demonstrated cardiac displacement and rotation. Part of the inferior vena cava flow passed into the left atrium via a patent foramen ovale: it is likely that this shunt increased in the upright position. After surgical closure of the patent foramen ovale and partial relocation of the heart (with a vicryl net) the patient has now remained free of symptoms for 5 years. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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