Unexplained hypoxemia in COPD with cardiac shunt
Respiratory Medicine Case Reports, ISSN: 2213-0071, Vol: 37, Page: 101661
2022
- 3Citations
- 5Captures
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Example: if you select the 1-year option for an article published in 2019 and a metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019. If you select the 3-year option for the same article published in 2019 and the metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019, 2018 and 2017.
Citation Benchmarking is provided by Scopus and SciVal and is different from the metrics context provided by PlumX Metrics.
Metrics Details
- Citations3
- Citation Indexes3
- Captures5
- Readers5
Case Description
In Chronic Obstructive Pulmonary Disease (COPD), hypoxemia is associated with multiple underlying mechanisms, of which one of the most significant is ventilation-perfusion (V/Q) mismatch, which is correctable with supplemental oxygen (O 2 ) therapy. Hypoxemia that is refractory to very high concentration of inspired O 2 can be indicative of cardiac defect with shunt, e.g., a patent foramen ovale (PFO) with right-to-left (R-T-L) shunt. In hypoxemic COPD patients, the diagnosis of a PFO requires a heightened sense of clinical suspicion along with careful assessment of other underlying possibilities. Platypnea-orthodeoxia and a non-response to the hyperoxia test, while not diagnostic, increase suspicion. A correct diagnosis of interatrial bypass needs to be confirmed with transthoracic echocardiogram and contrast transesophageal echocardiography. Presently, no data are available supporting the effectiveness of PFO closure in COPD patients to relieve symptoms and correct hypoxemia. We report a case of hypoxemic COPD with platypnea-orthodeoxia syndrome due to PFO. The decision of its closure with device after echocardiographic evaluation of right ventricular function has completely corrected refractory hypoxemia with improvement of SpO 2 and functional capacity. Thus, in selected COPD with refractory hypoxemia, closure of PFO should be considered as novel therapeutic target with improvement of quality of life and less likelihood of hospitalization.
Bibliographic Details
http://www.sciencedirect.com/science/article/pii/S2213007122000831; http://dx.doi.org/10.1016/j.rmcr.2022.101661; http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85129500075&origin=inward; http://www.ncbi.nlm.nih.gov/pubmed/35585906; https://linkinghub.elsevier.com/retrieve/pii/S2213007122000831; https://dx.doi.org/10.1016/j.rmcr.2022.101661
Elsevier BV
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