{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T10:58:36Z","timestamp":1740135516283,"version":"3.37.3"},"reference-count":5,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T00:00:00Z","timestamp":1658966400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T00:00:00Z","timestamp":1658966400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cardiovasc Disord"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Refractory hypoxemia after right ventricular myocardial infarction and concomitant SARS-CoV-2 infection represents an uncommon, yet particularly challenging clinical scenario. We report a challenging diagnostic case of refractory hypoxemia due to right-to-left shunt highlighting contemporary challenges and pitfalls in acute cardiovascular care associated with the current COVID-19 pandemic.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 52-year-old patient admitted for inferior acute myocardial infarction developed rapidly worsening hypoxemia shortly after primary percutaneous coronary intervention. RT-PCR screening for SARS-CoV-2 was positive, even though the patient had no prior symptoms. A computed tomography pulmonary angiogram excluded pulmonary embolism and showed only mild interstitial pulmonary involvement of the virus. Transthoracic echocardiogram showed severe right ventricular dysfunction and significant right-to-left shunt at the atrial level after agitated saline injection. Progressive improvement of right ventricular function allowed weaning from supplementary oxygen support. Patient was latter discharged with marked symptomatic improvement.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Refractory hypoxemia after RV myocardial infarction should be carefully addressed, even in the setting of other more common and tempting diagnoses. After exclusion of usual etiologies, right-to-left shunting at the atrial level should always be suspected, as this may avoid unnecessary and sometimes harmful interventions.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12872-022-02765-9","type":"journal-article","created":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T08:02:48Z","timestamp":1658995368000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Severe hypoxemia in a patient with right ventricular myocardial infarction and SARS-CoV-2 infection"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6317-4847","authenticated-orcid":false,"given":"Francisco","family":"Albuquerque","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro M.","family":"Lopes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catarina","family":"Br\u00edzido","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Strong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Jo\u00e3o","family":"Andrade","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"de Ara\u00fajo Gon\u00e7alves","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ant\u00f3nio","family":"Tralh\u00e3o","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,7,28]]},"reference":[{"issue":"8","key":"2765_CR1","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1001\/jama.2020.12839","volume":"324","author":"WJ Wiersinga","year":"2020","unstructured":"Wiersinga WJ, Rhodes A, Cheng AC, et al. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review. J Am Med Assoc. 2020;324(8):782\u201393. https:\/\/doi.org\/10.1001\/jama.2020.12839.","journal-title":"J Am Med Assoc"},{"issue":"1","key":"2765_CR2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/openhrt-2020-001497","volume":"8","author":"S Kitahara","year":"2021","unstructured":"Kitahara S, Fujino M, Honda S, et al. COVID-19 pandemic is associated with mechanical complications in patients with ST-elevation myocardial infarction. Open Hear. 2021;8(1):1\u20136. https:\/\/doi.org\/10.1136\/openhrt-2020-001497.","journal-title":"Open Hear"},{"issue":"37\u201338","key":"2765_CR3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.4414\/smw.2017.14491","volume":"147","author":"R Gr\u00fcbler Martin","year":"2017","unstructured":"Gr\u00fcbler Martin R, Olivier W, David B, et al. Basic concepts of heart-lung interactions during mechanical ventilation. Swiss Med Wkly. 2017;147(37\u201338):1\u201314. https:\/\/doi.org\/10.4414\/smw.2017.14491.","journal-title":"Swiss Med Wkly"},{"issue":"22","key":"2765_CR4","doi-asserted-by":"publisher","first-page":"2329","DOI":"10.1001\/jama.2020.6825","volume":"323","author":"JJ Marini","year":"2020","unstructured":"Marini JJ, Gattinoni L. Management of COVID-19 respiratory distress. J Am Med Assoc. 2020;323(22):2329\u201330. https:\/\/doi.org\/10.1001\/jama.2020.6825.","journal-title":"J Am Med Assoc"},{"issue":"1","key":"2765_CR5","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1186\/s13613-020-00692-6","volume":"10","author":"MJ Tobin","year":"2020","unstructured":"Tobin MJ, Laghi F, Jubran A. Caution about early intubation and mechanical ventilation in COVID-19. Ann Intensive Care. 2020;10(1):4\u20136. https:\/\/doi.org\/10.1186\/s13613-020-00692-6.","journal-title":"Ann Intensive Care"}],"container-title":["BMC Cardiovascular Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-022-02765-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12872-022-02765-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-022-02765-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,29]],"date-time":"2022-07-29T14:59:03Z","timestamp":1659106743000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmccardiovascdisord.biomedcentral.com\/articles\/10.1186\/s12872-022-02765-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,28]]},"references-count":5,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["2765"],"URL":"https:\/\/doi.org\/10.1186\/s12872-022-02765-9","relation":{},"ISSN":["1471-2261"],"issn-type":[{"type":"electronic","value":"1471-2261"}],"subject":[],"published":{"date-parts":[[2022,7,28]]},"assertion":[{"value":"27 April 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 July 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 July 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the ethics committee for health of Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal which waved the need for informed consent.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent for publication of patient\u2019s clinical details and images was obtained from the patient.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"334"}}