Acute hypoxia due to right to left blood shunting in a patient with atrial septal defect.

Acute right to left blood shunt is an unusual cause of acute hypoxia. We describe a case of a patient with an atrial septal defect who developed acute hypoxia due to cardiac tamponade. Acute haemopericardium developed as a complication of temporary transvenous cardiac pacing. Bubble contrast echocardiography confirmed right to left blood shunting at the atrial level. Acute hypoxaemia and the right to left blood shunt resolved when the pericardium was drained. The case underscores the importance of evaluating the presence of an intracardial shunt in patients with otherwise inexplicable hypoxia.

Unusual spontaneous repositioning of an amplatzer device embolized into the left atrium resulting in completed closure of atrial septal defect.

The authors described a rare case of spontaneous repositioning of an embolised Amplatzer occluder into the left atrium resulting in complete occlusion of a hemodynamically significant atrial septal defect, in the fossa ovalis, in a 70-year-old man. Only a slight central residual shunting was present, as was shown by transesophageal Doppler echocardiography performed immediately after the procedure, with no apparent shunt at 30, 60 and 120 days after the intervention.