Right Ventricular Infarction and Refractory Hypoxemia Following Coronary Artery Bypass Graft Surgery

Right ventricular (RV) infarction occurs in 19% to 51% of patients with left ventricular inferiorwall acute myocardial infarction. 1,2 The importance of RV infarction and its unique hemodynamicconsequences were not well understood until the early 1970s. Among these consequences arehemodynamic disturbances, which may be mistaken for left ventricular dysfunction, pericardialtamponade, and pulmonary embolism. Another serious consequence associated with RV infarctionis sudden right-to-left shunting through a previously unsuspected atrial septal defect (ASD) orpatent foramen ovale (PFO). We herein describe a patient in whom postoperative RV infarction wasassociated with refractory hypoxemia through a PFO