China
Africa
Explore chapters and articles related to this topic
Transition to extrauterine life
Published in Prem Puri, Newborn Surgery, 2017
Carlos E. Blanco, Eduardo Villamor
Anatomically, the foramen ovale comprises overlapping portions of septum primum and septum secundum, acting as a one-way flap valve allowing continuous right-to-left flow during fetal life.20 Immediately after birth, with the acute increase in pulmonary blood flow, left atrium pressure rises to exceed right atrium pressure, pushing septum primum rightward, against septum secundum, shutting the flap of the foramen ovale. Afterward, septum primum fuses to septum secundum, completing septation of the atria. However, in 20% to 25%, incomplete fusion leads to the persistence of the flap valve, leaving a patent foramen ovale.20 In general, individuals with patent foramen ovale are never identified because they have no symptoms. However, there is increasing interest in the evaluation and treatment of patent foramen ovale, which has been associated with various pathologic conditions, such as cryptogenic stroke, decompression sickness, platypnea–orthodeoxia syndrome, and migraine.21
Percutaneous closure of atrial septal defect and patent foramen ovale
Published in Debabrata Mukherjee, Eric R. Bates, Marco Roffi, Richard A. Lange, David J. Moliterno, Nadia M. Whitehead, Cardiovascular Catheterization and Intervention, 2017
Fabian Nietlispach, Bernhard Meier
Besides these diseases, other different pathologies are associated with a PFO, although the pathophysiology of the association is not yet fully understood: sleep apnea syndrome,9 high-altitude pulmonary edema,10 and platypnea orthodeoxia syndrome.11
Patent foramen ovale
Published in Jana Popelová, Erwin Oechslin, Harald Kaemmerer, Martin G St John Sutton, Pavel Žáček, Congenital Heart Disease in Adults, 2008
Jana Popelová, Erwin Oechslin, Harald Kaemmerer, Martin G St John Sutton, Pavel Žáček
A right-to-left shunt may be transient or intermittent: it is caused by increased right atrial pressure in pulmonary embolism or lung disease but, also, in cough, Valsalva maneuver or diving, and it may also be dependent on a change in position. The platypnea-orthodeoxia syndrome has been reported in elderly patients who are cyanotic and dyspneic when sitting — the problems resolve when lying. These complaints are explained by a right-to-left shunt in the presence of PFO and a prominent Eustachian valve, directing blood flow from the vena cava inferior to PFO.8
Amplatzer patent foramen ovale occluder: safety and efficacy
Published in Expert Review of Medical Devices, 2019
Raouf Madhkour, Andreas Wahl, Fabien Praz, Bernhard Meier
All affections linked to a rise of the pulmonary arterial pressures may favor right to left shunting through the PFO due to subsequent pressure increase in the right atrium. A typical and common condition is chronic obstructive pulmonary disease in which hypoxemia has been described to worsen in the presence of a PFO [47]. Intermittent or continuous right to left shunting through the PFO may also exist even in the absence of pulmonary hypertension. Exercise desaturation may represent a frequently underdiagnosed manifestation which PFO closure may cure [48]. Another rare condition typically seen in the elderly is the platypnea-orthodeoxia syndrome in which subjects report paradoxical dyspnea caused by desaturation in the upright position which is relieved by recumbency. This condition is often the result of degenerative anatomic changes (spine shortening, diaphragm dysfunction, prominent Eustachian Valve) engendering a right to left shunt by opening the PFO when sitting up [49].
The dilemma of refractory hypoxemia after inferior wall myocardial infarction
Published in Baylor University Medical Center Proceedings, 2018
Aymen Albaghdadi, Mohamed Teleb, Mateo Porres-Aguilar, Mateo Porres-Munoz, Alejandro Marmol-Velez
A patent foramen ovale (PFO) may allow right-to-left interatrial shunting when the pressure in the right atrium exceeds that of the left as in Valsalva maneuver.1 Significant right-to-left shunting may be present in some patients upon positional changes, leading to the so-called platypnea-orthodeoxia syndrome.2 A PFO may allow for paradoxical embolization, which may be the explanation for a proportion of cases of cryptogenic stroke.3 Refractory hypoxemia with an unremarkable chest radiograph or lung exam should always prompt suspicion for a right-to-left shunt. The occurrence of right ventricular infarction, which complicates 40% of posterior wall myocardial infarction (MI), may lead to right-to-left shunting, due to restrictive diastolic physiology of the ischemic right ventricle.4–12
Patent Foramen Ovale Closure, A Contemporary Review
Published in Structural Heart, 2018
Raouf Madhkour, Bernhard Meier
The platypnea-orthodeoxia syndrome is diagnosed rarely but it may be underdiagnosed. It occurs typically in the elderly with a PFO. It is a chronic condition, characterized by dyspnea and desaturation in the upright position. This position produces a right to left atrial shunt through the PFO. The etiology is most often related to an aging anatomy with spine shortening and pushed up or malfunctioning diaphragms, as well as to a prominent Eustachian valve in the right atrium, directing the flow from the inferior vena cava to the PFO.44