RESUMO
Right ventricular (RV) infarction is not an uncommon complication of acute left ventricular infarction. It has been established that RV dysfunction post myocardial infarction (MI) is associated with increased mortality and morbidity. When RV infarction occurs in a patient with previously dormant patent foramen ovale (PFO), an unusual presentation of persistent refractory hypoxaemia ensues. We present a case of new RV infarction in a patient with underlying ischaemic cardiomyopathy, which was complicated by acute right-to-left shunting through the PFO. He was treated with percutaneous coronary intervention (PCI) and subsequent percutaneous PFO closure. We will also review the existing literature with regards to diagnostic and management strategies for patients with this unusual sequelae of MI.
Assuntos
Hipóxia/etiologia , Infarto do Miocárdio/complicações , Disfunção Ventricular Esquerda/etiologia , Forame Oval Patente/complicações , Forame Oval Patente/cirurgia , Humanos , Hipóxia/terapia , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/cirurgia , Intervenção Coronária PercutâneaAssuntos
Dispneia/etiologia , Ecocardiografia/métodos , Forame Oval Patente/complicações , Postura/fisiologia , Idoso , Procedimentos Cirúrgicos Cardíacos/métodos , Diagnóstico Diferencial , Dispneia/diagnóstico por imagem , Dispneia/fisiopatologia , Forame Oval Patente/diagnóstico por imagem , Forame Oval Patente/cirurgia , Humanos , Masculino , SíndromeRESUMO
Non-coronary incidental findings are not rare. Kirsch et al found 67% non-coronary abnormalities with coronary computed tomography angiography (CCTA). Radiologists are expected to identify the extracoronary, intra- and para-cardiac anatomical structures and distinguish them from pathologic processes in CCTA. We have reviewed 2000 CCTA studies done at our institution with 64-MDCT. This pictorial essay presents case studies of non-atherosclerotic cardiovascular findings to recognize cardiac anatomic structures and how to distinguish them from pathologic processes. Correct interpretation of benign, clinically insignificant findings is crucial to avoid unnecessary additional imaging tests.