• Vol. 40 No. 7, 327–329
  • 15 July 2011

Refractory Hypoxia in Right Ventricular Infarction



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Acute myocardial infarction (MI) involving the right ventricle is a rare event. Right ventricular myocardial infarction (RVMI) is associated with infarction of the inferior wall of the left ventricle, occurring in more than one third of such cases. Patent foramen ovale (PFO) is an anatomic inter-atrial communication with the potential risk for shunting of blood. This usually closes within weeks to months after birth but in approximately 27% of adults, shunting through the PFO occurs. This defect is usually of no clinical consequence. However in the setting of right ventricular failure, high right ventricular diastolic pressure can cause a right-to-left shunting via the PFO, resulting in systemic hypoxaemia refractory to supplemental oxygen.

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