Right to Left Shunting Through Patent Foramen Ovale During Simulated Episodes of Obstructive Sleep Apnea

Konečný, Tomáš; Khann, Amber D.; Novák, Jan; Jama, Abdi A.; Bukartyk, Jan; Orban, Marek; Kára, Tomáš; Borlaug, Barry A.; Somers, Virend K.; Reeder, Guy S.

doi:10.1016/s0735-1097(12)62138-x

Cited by 2 publications

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“…33,34 It is an alternative maneuver that enhances right-to-left shunting. 35 The modified Muller maneuver is forced inspiration against pinched nostrils, which should deliver a similar physiological effect as the original maneuver. 36 Obstructive sleep apnea syndrome is a common disease that induces right-to-left shunting in patients with PFO.…”

Section: Cryptogenic Stroke With Pfomentioning

confidence: 99%

The Role of Transcranial Doppler in Detecting Patent Foramen Ovale

Hutayanon

Muengtaweepongsa

2022

Journal for Vascular Ultrasound

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Air embolic signals detected in the intracranial arteries using transcranial Doppler after intravenous injection of agitated saline bubbles indicate right-to-left cardiac shunting. They prove that emboli from venous sites can bypass the lungs and flow to the intracranial arteries. The Valsalva maneuver immediately after an intravenous injection of agitated saline bubbles helps the air bubbles pass through the shunt. If the air embolic signal appears in the intracranial arteries without the Valsalva maneuver, the shunting is highly significant to the etiology of embolism. Transcranial Doppler to detect air embolic signals after intravenous injection of agitated saline bubbles may not be mandatory to diagnose and treat patent foramen ovale; however, as with echocardiography, transcranial Doppler is considered a noninvasive, convenient, and low-cost investigation. The test should be helpful to confirm the significance of the corresponding patent foramen ovale.

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Section: Cryptogenic Stroke With Pfomentioning

confidence: 99%

The Role of Transcranial Doppler in Detecting Patent Foramen Ovale

Hutayanon

Muengtaweepongsa

2022

Journal for Vascular Ultrasound

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“…There are several proposed mechanisms for the increase in RTLS seen in OSA (Figure 2). An increase in negative intrathoracic pressure (as seen during apneic episodes when a patient attempts to breathe against a closed glottis) causes a steady increase in right atrial pressure (RA) at which point the RA exceeds left atrial (LA) pressure (Beelke et al, 2002;Konecny et al, 2012). Another proposed mechanism is that apnea-induced hypoxemia and hypercapnia increase pulmonary arteriolar resistance and vasoconstriction, causing the transient elevation in pulmonary arterial pressure and subsequently increased right-sided pressure.…”

Section: Introductionmentioning

confidence: 99%

Obstructive Sleep Apnea (OSA) and Patent Foramen Ovale (PFO), the “Perfect Storm” for a Cryptogenic Stroke? Case Series of Four Patients

et al. 2022

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We were intrigued by the finding of severe obstructive sleep apnea (OSA) in patients referred to our Sleep Clinic with a history of stroke at a relatively young age, in the setting of a patent foramen ovale (PFO). This prompted us to do a literature search to see the association of OSA with stroke in such a patient population. The correlation of PFOs with cryptogenic strokes is well established, as is that of OSA with stroke. However, not many studies have looked at the correlation between OSA and PFO in patients with cryptogenic strokes.

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Right to Left Shunting Through Patent Foramen Ovale During Simulated Episodes of Obstructive Sleep Apnea

Cited by 2 publications

References 0 publications

The Role of Transcranial Doppler in Detecting Patent Foramen Ovale

The Role of Transcranial Doppler in Detecting Patent Foramen Ovale

Obstructive Sleep Apnea (OSA) and Patent Foramen Ovale (PFO), the “Perfect Storm” for a Cryptogenic Stroke? Case Series of Four Patients

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