Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Background: Four-dimensional flow magnetic resonance imaging (MRI) enhances the evaluation of complex cardiovascular diseases. We used MRI and advanced imaging modalities to assess a right-to-left shunt through an atrial septal defect without pulmonary hypertension (PH).
Case Summary: An 84-year-old woman with persistent hypoxemia was found to have a significant right-to-left shunt without PH. Computed tomography angiography revealed severe aortic tortuosity compressing the right atrium, likely contributing to continuous shunting. Four-dimensional flow MRI visualized the shunt and quantified a Q/Q ratio of 0.61, consistent with invasive measurements.
Discussion: Unlike classic platypnea-orthodeoxia syndrome, extreme aortic tortuosity may cause persistent right-to-left shunting even in the supine position. This case highlights how age-related anatomical changes contribute to intracardiac shunting and underscores the utility of advanced imaging.
Take-home Message: Right-to-left shunting without PH can persist because of anatomical factors. In this case, a correct diagnosis was obtained through comprehensive imaging, including 4-dimensional flow MRI.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273850 | PMC |
| http://dx.doi.org/10.1016/j.jaccas.2025.103853 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Predictive value of patent foramen ovale diameter for cryptogenic stroke and age-related differences.
Front Cardiovasc Med
August 2025
Department of Ultrasound Imaging, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Introduction: Patent foramen ovale (PFO) is associated with cryptogenic stroke (CS), whereas not all PFO carriers experience strokes. Current risk assessment tools like the Risk of Paradoxical Embolism (RoPE) scoring system and PFO-Associated Stroke Causal Likelihood (PASCAL) system have limitations, particularly in elderly populations. This study aims to explore risk factors for PFO-related CS and evaluate age-related differences between younger and elderly patients.
View Article and Find Full Text PDFCurrent Practices for Bronchopulmonary Dysplasia-Associated Pulmonary Hypertension in Neonates: A Survey Study in Spain.
Pediatr Pulmonol
September 2025
Department of Neonatology, La Paz University Hospital, Madrid, Spain.
Objective: To describe national patterns in the screening, diagnosis, and clinical management of bronchopulmonary dysplasia-associated pulmonary hypertension (BPD-PH) in Spanish neonatal intensive care units (NICUs) and assess the need for standardized screening and management protocols and unified follow-up strategies.
Methods: A 20-question electronic survey was distributed to all Level III NICUs in the Spanish public health system to evaluate practices in BPD-PH screening, diagnosis, and clinical management. Results were analyzed globally and by NICU level (IIIB vs.
A Delayed Presentation of a Sinus Venosus Atrial Septal Defect.
Cureus
September 2025
Interventional Cardiology, University of Rochester Medical Center, Rochester, USA.
Sinus venosus atrial septal defects (ASDs) are rare congenital anomalies that result from an abnormality of the junction between the right atrium, superior vena cava (SVC), and pulmonary veins. This defect causes right-to-left shunting, which can lead to progressive right heart enlargement. We present a case of a 59-year-old man with a history of hypertension and hyperlipidemia who presented with dyspnea and newly diagnosed atrial flutter.
View Article and Find Full Text PDFConcomitant carcinoid heart disease and patent foramen ovale: a case report and review of literature.
Cardiooncology
September 2025
Hospital Distrital de Santarém, Santarém, Portugal.
Background: Carcinoid Heart Disease (CHD) primarily affects the right heart valves, while left heart involvement is rare and often associated with a patent foramen ovale (PFO). Early identification of a PFO in CHD can be critical to patient outcomes. A 61-year-old woman with metastatic neuroendocrine tumor presented with worsening breathlessness and hypoxemia.
View Article and Find Full Text PDFReduced pulmonary vascular bed volume in cryptogenic stroke patients with patent foramen ovale: a myocardial contrast echocardiography study.
Quant Imaging Med Surg
September 2025
Department of Ultrasound, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China.
Background: Pulmonary vascular bed volume (PVBV) in cryptogenic stroke patients with patent foramen ovale (PFO) has not been well characterized. This study examined PVBV in cryptogenic stroke patients with suspected PFO.
Methods: A total of 469 patients underwent agitated saline contrast transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) between January 2021 and December 2024.