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Pulmonary hypertension induced by drugs and toxins
Published in Philippe Camus, Edward C Rosenow, Drug-induced and Iatrogenic Respiratory Disease, 2010
Kim Bouillon, Yola Moride, Lucien Abenhaim, Marc Humbert
Non-steroidal anti-inflammatory drugs (NSAIDs) and selective serotonin-reuptake inhibitors (SSRIs) may be associated with pulmonary hypertension in the fetus or in the newborn after antenatal or postnatal exposure (these drugs are known to cross the placenta). Among newborns, these drug classes have been reported to be associated with idiopathic PPHN. This syndrome is due to an increased pulmonary vascular resistance that prevents normal pulmonary blood flow and causes a right-to-left shunt through persistent fetal channels (i.e. the patent foramen ovale and patent ductus arteriosus).104 The prevalence of PPHN is estimated at 2 per 1000 live births.105 PPHN is suspected when faced with neonatal hypoxaemia, which is often refractory and is associated with a high mortality (11 per cent).105
Transcatheters for closure of patent foramen ovales
Published in Expert Review of Medical Devices, 2018
Gianluca Rigatelli, Marco Zuin
As a matter of fact, the ostium secundum ASD is a true defect of the atrial septum which involves the fossa ovalis region and usually causes a left-to-right shunt (LRS). Both the magnitude and direction of the blood flow through an ASD depend on the size of the defect and the relative diastolic filling properties of both ventricles. Conditions that may reduce the left ventricle compliance and the even the presence of a mitral stenosis increase the LRS, whereas conditions that reduce right ventricle compliance decrease the LRS or may cause a right-to-left shunt (RLS). Specifically, a LRS is defined as significant when the Qp/Qs ratio is >1.5:1 or when the right chambers are dilated [9].