Changes in Intracardiac Shunt Elicited by Pneumonia

Radionuclide studies effectively demonstrate changes in cardiopulmonary hemodynamics and have been clinically used to demonstrate intracardiac shunts. The authors present a 6-month-old child with a history of a patent foramen ovale and pulmonary hypertension, presumably due to a left diaphragmatic hernia, who demonstrated accentuated pulmonary hypertension from pneumonia resulting in a right to left shunt. A perfusion scan documented a right-to-left shunt that disappeared on a follow-up lung scan as the patient responded to medical management. In a potential surgery candidate, it is prudent to perform quantitative intracardiac studies after the conditions altering cardiopulmonary hemodynamics are stabilized or treated.