Transient right-to-left shunt in massive pulmonary embolism.

作者: George Panoutsopoulos , Ioannis Ilias , Ioulia Christakopoulou

DOI: 10.1007/BF02987863

关键词: Perfusion scanningShuntingIntracardiac injectionMedicineAngiographyRight-to-left shuntCardiologyPulmonary embolismRadiologyShunt (medical)Arteriovenous AnastomosisInternal medicine

摘要: A 56-yr-old man, two months after an operation for acoustic neurinoma, gradually developed dyspnea. Massive pulmonary embolism (MPE), with a significant right-to-left (R-L) shunt, was seen in perfusion scan of the lungs Tc-99m MAA. Radioactivity noted thyroid, spleen, kidneys and brain. cardiac ultrasound study did not reveal intracardiac shunting. few days later, when patient’s condition improved, another show whereas subsequent digital subtraction angiographic confirmed diagnosis MPE but failed to cause shunt. In absence any possible pathophysiological mechanism, explain observed R-L we deduce that particles MAA might have passed through precapillary arteriovenous anastomoses and/or dilated capillaries, as result highly increased vascular pressure due MPE.

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