It all depends: A case of a position-dependent intracardiac shunt

      An 87-year-old woman presented to clinic for evaluation of knee pain. On arrival, vital signs showed oxygen saturation (SpO2) of 87-88% on room air. She had no chest pain or dyspnea, and had ambulated to the clinic without assistive devices or resting. Medical history included hypertension, acid reflux, and incompletely treated latent tuberculosis. Home medications included losartan and omeprazole. Her hypoxia persisted on multiple rechecks, and she was placed on supplemental oxygen (O2) and referred to the Emergency Department (ED).


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