Schuiteman Emily, Verrill Thomas, Mina Nader, Dalal Bhavinkumar
Department of Internal Medicine, Beaumont Hospital - Royal Oak, Royal Oak, MI, 48073, USA.
Department of Cardiology, Beaumont Hospital - Royal Oak, Royal Oak, MI, 48073, USA.
Respir Med Case Rep. 2017 May 30;22:28-30. doi: 10.1016/j.rmcr.2017.05.008. eCollection 2017.
A patent foramen ovale (PFO) is found in around 25-30% of patients. The discovery is often made only on autopsy, as most PFOs are clinically silent and any inter-atrial blood exchange typically shunts from the left to right heart [1]. Thus, when a patient presents with hypoxic respiratory failure, concern for presence of a PFO is rarely at the top of the differential. However, in the setting of elevated right heart pressures, PFOs can become of great hemodynamic importance and can lead to deadly complications, including right to left shunting and refractory hypoxic respiratory failure. We present an unusual care of constrictive pericarditis leading to significant shunting through a PFO, and resultant hypoxic respiratory failure which only resolved with PFO closure.
约25%-30%的患者存在卵圆孔未闭（PFO）。这种情况通常仅在尸检时才被发现，因为大多数卵圆孔未闭在临床上并无症状，且任何心房间的血液交换通常都是从左心房向右心房分流[1]。因此，当患者出现低氧性呼吸衰竭时，很少会首先考虑到卵圆孔未闭的存在。然而，在右心压力升高的情况下，卵圆孔未闭可能具有重要的血流动力学意义，并可能导致致命的并发症，包括右向左分流和难治性低氧性呼吸衰竭。我们报告了一例因缩窄性心包炎导致通过卵圆孔未闭出现大量分流，并由此引发低氧性呼吸衰竭的罕见病例，该呼吸衰竭仅在卵圆孔未闭封堵后才得以缓解。
