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Another instance of development of a right-to-left shunt is Reverse Lutembacher syndrome, in which an additional cardiac anomaly i.
Scuba diving is associated with decompression sickness and air emboli, which can be a mechanism of cerebral ischemia, especially in patients with a right-to-left shunt, such as with PFO.
A bedside echocardiography and chest computed tomography revealed no evidence of right-to-left shunt.
Transthoracic echocardiography showed a patent foramen ovale, with no signs of structural anomalies, such as right-to-left shunt or intrapulmonary shunt, which could potentially lead to respiratory failure.
Lung perfusion scan with Tc-99m MAA was performed and showed focal tracer uptake at the region of the brain, stomach, and both kidneys indicating right-to-left shunt (Figure 2).
Pulmonary arteriovenous malformations generally do not affect cardiac hemodynamics in contrast to systemic AVMs, however, degree of right-to-left shunt from pulmonary artery to vein determines the severity of clinical symptoms.
An interatrial defect of 6 mm with a right-to-left shunt was determined with the angiography and TTE after the procedure.
00]), and more weakly with low oxygen saturations reflecting a larger right-to-left shunt (adjusted OR 0.
The presence of acute neurologic findings in a patient with a PICC should raise the question of whether the catheter is in the arterial system or in the venous system with a right-to-left shunt.
The increased right-sided pressure then favors a right-to-left shunt and increased embolization.
It is proposed that the patient also had paradoxical air embolism related to a physiological pulmonary or cardiac right-to-left shunt.