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Intrapulmonary Shunting in Primary Pulmonary Hypertension : An Observation in Two Patients Treated With Epoprostenol Sodium

Pablo F. Castro; Robert C. Bourge; David C. McGiffin; Raymond L. Benza; Pohoey Fan; Nanette B. Pinkard; Michael D. McGoon
Author and Funding Information

Affiliations: From the Catholic University of Chile, Santiago,  From the Division of Cardiovascular Disease, Department of Medicine, The University of Alabama at Birmingham, Birmingham,  From the Division of Cardiothoracic Surgery, Department of Surgery, The University of Alabama at Birmingham, Birmingham,  From the Division of Anatomic Pathology, Department of Pathology, The University of Alabama at Birmingham, Birmingham,  From the Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn

Affiliations: From the Catholic University of Chile, Santiago,  From the Division of Cardiovascular Disease, Department of Medicine, The University of Alabama at Birmingham, Birmingham,  From the Division of Cardiothoracic Surgery, Department of Surgery, The University of Alabama at Birmingham, Birmingham,  From the Division of Anatomic Pathology, Department of Pathology, The University of Alabama at Birmingham, Birmingham,  From the Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn

Affiliations: From the Catholic University of Chile, Santiago,  From the Division of Cardiovascular Disease, Department of Medicine, The University of Alabama at Birmingham, Birmingham,  From the Division of Cardiothoracic Surgery, Department of Surgery, The University of Alabama at Birmingham, Birmingham,  From the Division of Anatomic Pathology, Department of Pathology, The University of Alabama at Birmingham, Birmingham,  From the Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn

Affiliations: From the Catholic University of Chile, Santiago,  From the Division of Cardiovascular Disease, Department of Medicine, The University of Alabama at Birmingham, Birmingham,  From the Division of Cardiothoracic Surgery, Department of Surgery, The University of Alabama at Birmingham, Birmingham,  From the Division of Anatomic Pathology, Department of Pathology, The University of Alabama at Birmingham, Birmingham,  From the Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn

Affiliations: From the Catholic University of Chile, Santiago,  From the Division of Cardiovascular Disease, Department of Medicine, The University of Alabama at Birmingham, Birmingham,  From the Division of Cardiothoracic Surgery, Department of Surgery, The University of Alabama at Birmingham, Birmingham,  From the Division of Anatomic Pathology, Department of Pathology, The University of Alabama at Birmingham, Birmingham,  From the Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn


1998 by the American College of Chest Physicians


Chest. 1998;114(1):334-336. doi:10.1378/chest.114.1.334
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Published online

Abstract

Continuous intravenous infusion of epoprostenol sodium in selected patients with primary pulmonary hypertension improves symptoms and survival. This report describes two patients with primary pulmonary hypertension treated with epoprostenol in whom intrapulmonary shunting and severe hypoxemia occurred. Intrapulmonary shunting was confirmed by contrast echocardiography showing delayed appearance of bubbles in the left cardiac chambers after peripheral venous injection of agitated saline solution.


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