Ibrahim Hussain, Khan Adnan, Nishi Shawn P, Fujise Ken, Gilani Syed
University of Texas Medical Branch, 301 University Boulevard, 5.106 John Sealy Annex, Galveston, TX 77555-0553, USA.
Case Rep Pulmonol. 2017;2017:9848696. doi: 10.1155/2017/9848696. Epub 2017 Oct 16.
Dyspnea accounts for more than one-fourth of the hospital admissions from Emergency Department. Chronic conditions such as Chronic Obstructive Pulmonary Disease, Congestive Heart Failure, and Asthma are being common etiologies. Less common etiologies include conditions such as valvular heart disease, pulmonary embolism, and right-to-left shunt (RLS) from patent foramen ovale (PFO). PFO is present in estimated 20-30% of the population, mostly a benign condition. RLS via PFO usually occurs when right atrium pressure exceeds left atrium pressure. RLS can also occur in absence of higher right atrium pressure. We report one such case that highlights the importance of high clinical suspicion, thorough evaluation, and percutaneous closure of the PFO leading to significant improvement in the symptoms.
呼吸困难占急诊科住院患者的四分之一以上。慢性阻塞性肺疾病、充血性心力衰竭和哮喘等慢性疾病是常见病因。较少见的病因包括瓣膜性心脏病、肺栓塞以及卵圆孔未闭(PFO)导致的右向左分流(RLS)。估计20%-30%的人群存在PFO,大多为良性情况。通过PFO的RLS通常在右心房压力超过左心房压力时发生。在没有较高右心房压力的情况下也可能发生RLS。我们报告了这样一个病例,强调了高度临床怀疑、全面评估以及经皮闭合PFO对显著改善症状的重要性。