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These routes include moving through a patent foramen ovale (a congenital hole connecting the right and left atria of the heart), a ventricular septal defect (a congenital hole connecting the ventricles), or a pulmonary arteriovenous fistula, where arteries in the lungs connect directly to veins without capillaries in between.
Atrial septal defect (ASD) is a congenital heart defect in which blood flows between the atria (upper chambers) of the heart.Some flow is a normal condition both pre-birth and immediately post-birth via the foramen ovale; however, when this does not naturally close after birth it is referred to as a patent (open) foramen ovale (PFO).
Atrial septal defect with left-to-right shunt. The left and right sides of the heart are named from a dorsal view, i.e., looking at the heart from the back or from the perspective of the person whose heart it is. There are four chambers in a heart: an atrium (upper) and a ventricle (lower) on both the left and right sides. [1]
About 50% of individuals with Ebstein's anomaly have an associated shunt between the right and left atria, either an atrial septal defect or a patent foramen ovale. [ 6 ] Electrophysiologic abnormalities
Eisenmenger syndrome or Eisenmenger's syndrome is defined as the process in which a long-standing left-to-right cardiac shunt caused by a congenital heart defect (typically by a ventricular septal defect, atrial septal defect, or less commonly, patent ductus arteriosus) causes pulmonary hypertension [1] [2] and eventual reversal of the shunt into a cyanotic right-to-left shunt.
The first is the foramen ovale (the valve present between them called eustachian valve) which shunts blood from the right atrium to the left atrium. The second is the ductus arteriosus which shunts blood from the pulmonary artery (which, after birth, carries blood from the right side of the heart to the lungs) to the descending aorta.
An uncorrected left-to-right shunt can progress to a right-to-left shunt; this process is termed Eisenmenger syndrome. [3] This is seen in Ventricular septal defect, Atrial septal defect, and patent ductus arteriosus, and can manifest as late as adult life. This switch in blood flow direction is precipitated by pulmonary hypertension due to ...
In the presence of a right-to-left shunt of the heart, such as a patent foramen ovale, venous bubbles may enter the arterial system, resulting in an arterial gas embolism. [ 7 ] [ 57 ] A similar effect, known as ebullism , may occur during explosive decompression , when water vapour forms bubbles in body fluids due to a dramatic reduction in ...