Optimal Conservative Management Resolves Refractory Hypoxemia in Patient with Right Myocardial Infarction Complicated by PFO-Induced Shunting

Methodist Debakey Cardiovasc J. 2023 Mar 27;19(1):20-25. doi: 10.14797/mdcvj.1191. eCollection 2023.

Abstract

Inferior myocardial infarction is often accompanied by infarction of the right ventricle (RV). Uncommon RV infarction cases with patent foramen ovale (PFO) shunt, leading to severe persistent hypoxemia even without any pulmonary embolism involvement and often requiring invasive intervention, have been documented previously. We report a patient with RV infarction and right-to-left shunt via PFO who improved with only early revascularization and optimal standard treatment. This condition may not necessitate any invasive intervention if it is treated and monitored per standard procedures. Clinicians should consider the possibility of a right-to-left shunt in patients with RV infarction and persistent hypoxemia to implement appropriate therapeutic interventions.

Keywords: hypoxemia; patent foramen ovale; right ventricular infarction; right-to-left intracardiac shunt.

Publication types

  • Case Reports

MeSH terms

  • Conservative Treatment / adverse effects
  • Foramen Ovale, Patent* / complications
  • Foramen Ovale, Patent* / diagnostic imaging
  • Foramen Ovale, Patent* / therapy
  • Heart Ventricles
  • Humans
  • Hypoxia / diagnosis
  • Hypoxia / etiology
  • Hypoxia / therapy
  • Myocardial Infarction* / complications