PMC6812136_01
Transthoracic echocardiography demonstrating atrial septal defect by color Doppler.
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There was evidence of an atrial septal shunt (Fig. 1), however agitated saline or contrast was not preformed.
79 year old woman with central cyanosis. Lips changed from patient's normal skin color to blue within 10 minutes of standing. (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)
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Within 10 minutes of standing her lips would change from flesh colored pink to blue (Fig. 2).
79 year old woman with cyanotic finger tips. A: dorsal surface. B: volar surface.
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Upon closer physical examination, with patient standing, cyanosis was also noted on her fingertips (Fig. 3).
Cardiac Magnetic Resonance Imaging (cMRI). Cross sectional section revealing large right atrium and moderate sized atrial septal defect (arrow).
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Imaging confirmed a large ASD with a Qp/Qs ratio of 1.5 (Fig. 4).