Detection of intrapulmonary shunts in schistosomal corpulmonale

ABSTRACT

Some patients with schistosomal cor pulmonale [S-Corp] have central cyanosis, the mechanism of which is not known, but two suggestions were reported; opening of foramen ovale or shunts [intrapulmonary vascular dilatations, IPVD] inside the lungs. Evidence of the later mechanism is studied here by two methods: 1- Injection of indocyanine green dye with video recording of contrast enhanced [CE] echo, appearance of dye in left side after 5-6 cycles of appearance in right side is considered a sign of presence of shunt. 2- Blood gas analysis at rest and after 60% O2 inhalation. Ten patients with S- Corp were studied, two with central cyanosis. None had lung fibrosis or COPD. Atrial septal defect or patent foramen ovale was excluded in all cases. Evidence of shunt by CE echo was revealed in the two patients with cyanosis. Two other patients had evidence of shunt by gas analysis, but negative CE echo