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European Heart Journal 1986 7(6):541-544;
Copyright © 1986 by the European Society of Cardiology.
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© 1986 The European Society of Cardiology

Onset of right-to-left shunting through a foramen ovale in a 70-year-old woman: successful surgical treatment

D. PITCHER*,¶, P. FLETCHER§, G. LASZLO{dagger}, G. KEEN{ddagger} and J. R. REES*

*Department of Cardiology, Bristol Royal Infirmary Bristol
{dagger}Department of Respiratory Medicine, Bristol Royal Infirmary Bristol
{ddagger}Department of Cardiac Surgery, Bristol Royal Infirmary Bristol
§Department of Medicine, Yeovil District Hospital U.K.

Received 9 December 1985; .

Abstract

A 70-year-old woman presented with disabling breathlessness. She was found to have severe arterial hypoxaemia due to isolated right-to-left shunting through a patent foramen ovale. In the absence of pulmonary hypertension or evidence of right ventricular dysfunction this is attributed to reduced right atrial compliance. The phasic nature of the shunt, which occurred only during atrial filling, supports this view. Surgical closure of the foramen abolished the hypoxaemia and her symptoms.

Key Words: Patent foramen ovale • blood gas analysis • dyspnoea


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