Philippe Estagnasie, MD; Genevieve Le Bourdelles, MD; Laurence Mier, MD; Francois Coste, MD; Didier Dreyfuss, MD
Estagnasie P, Le Bourdelles G, Mier L, Coste F, Dreyfuss D. Use of Inhaled Nitric Oxide To Reverse Flow through a Patent Foramen Ovale during Pulmonary Embolism. Ann Intern Med. 1994;120:757-759. doi: 10.7326/0003-4819-120-9-199405010-00007
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Published: Ann Intern Med. 1994;120(9):757-759.
The presence of a patent foramen ovale during pulmonary embolism may promote right-to-left shunting when right atrial pressure exceeds that in the left atrium. This may cause severe hypoxemia and paradoxical embolism . The diagnosis of this complication has benefited from contrast transesophageal echocardiography . Invasive procedures, such as transcatheter or surgical closure, are usually required  but may not be easily done in unstable patients. Reversing the right-to-left atrial pressure gradient may promote closure of the patent foramen ovale. We report an example of this reversal using inhaled nitric oxide, a potent pulmonary vasodilator [4-7].
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Cardiology, Emergency Medicine, Pulmonary/Critical Care, Venous Thromboembolism, Pulmonary Embolism.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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