Atrial Septal Defect With Right-to-Left Shunt Without Pulmonary Hypertension: Diagnosis Through Multimodality Imaging.

ABSTRACT:

Background

Four-dimensional flow magnetic resonance imaging (MRI) enhances the evaluation of complex cardiovascular diseases. We used MRI and advanced imaging modalities to assess a right-to-left shunt through an atrial septal defect without pulmonary hypertension (PH).

Case summary

An 84-year-old woman with persistent hypoxemia was found to have a significant right-to-left shunt without PH. Computed tomography angiography revealed severe aortic tortuosity compressing the right atrium, likely contributing to continuous shunting. Four-dimensional flow MRI visualized the shunt and quantified a Q_p/Q_s ratio of 0.61, consistent with invasive measurements.

Discussion

Unlike classic platypnea-orthodeoxia syndrome, extreme aortic tortuosity may cause per

SUBMITTER: Sekii R 

PROVIDER: S-EPMC12273850 | biostudies-literature | 2025 Jun

REPOSITORIES: biostudies-literature