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Titolo:
Pharmacologic exposure of an occult atrial septal defect
Autore:
Mackenzie, IM; Banning, A; Dyar, O;
Indirizzi:
John Radcliffe Hosp, Nuffield Dept Anaesthet, Oxford OX3 9DU, England JohnRadcliffe Hosp Oxford England OX3 9DU thet, Oxford OX3 9DU, England John Radcliffe Hosp, Dept Cardiol, Oxford OX3 9DU, England John Radcliffe Hosp Oxford England OX3 9DU diol, Oxford OX3 9DU, England
Titolo Testata:
CRITICAL CARE MEDICINE
fascicolo: 9, volume: 29, anno: 2001,
pagine: 1832 - 1834
SICI:
0090-3493(200109)29:9<1832:PEOAOA>2.0.ZU;2-U
Fonte:
ISI
Lingua:
ENG
Soggetto:
PATENT FORAMEN OVALE; TWO-DIMENSIONAL ECHOCARDIOGRAPHY; REFRACTORY HYPOXEMIA; ORTHODEOXIA SYNDROME; PLATYPNEA; SHUNT; DIAGNOSIS;
Keywords:
heart septal defects; atrial; metaraminol; echocardiography; transesophageal;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
21
Recensione:
Indirizzi per estratti:
Indirizzo: Mackenzie, IM John Radcliffe Hosp, Nuffield Dept Anaesthet, Oxford OX3 9DU, England John Radcliffe Hosp Oxford England OX3 9DU X3 9DU, England
Citazione:
I.M. Mackenzie et al., "Pharmacologic exposure of an occult atrial septal defect", CRIT CARE M, 29(9), 2001, pp. 1832-1834

Abstract

Objective: To describe the diagnostic technique used to identify the presence of a symptomatic interatrial shunt obscured by normal intracardiac pressures and to discuss the unusual findings in this case and their relevance to the investigation of patients with unexplained hypoxemia. Design. Case report. Setting. Intensive care unit of a university teaching hospital. Patient. A patient with a variant of the platypnea-orthodeoxia syndrome. Interventions. Intravenous administration of metaraminol. Measurements and Main Results. Clinical examination and routine investigations ruled out pneumonia or myocardial infarction as a cause of respiratoryfailure, and pulmonary angiography was normal other than for the demonstration of an interatrial communication. Repeated transthoracic echocardiograms failed to indicate the presence of a significant interatrial shunt that was eventually detected following temporary shunt reversal with intravenous metaraminol and confirmation by bubble-contrast transesophageal echocardiography and right heart catheter studies. Conclusions. Symptomatic right-to-left intracardiac shunt may occur in patients with normal intracardiac and pulmonary artery pressures. The presenceof a significant shunt cannot be ruled out by transthoracic echocardiography without the use of bubble contrast.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/11/20 alle ore 18:51:58