PMC5470528_01
Right ventricular pressure tracing demonstrating the "square root sign" (arrow).
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Right heart catheterization (RHC) was then performed and showed an equalization of diastolic pressures, as well as the characteristic "square root sign," consistent with constrictive physiology (Fig. 1).
Color-flow doppler demonstrating moderate shunting through a PFO (arrow).
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The following day he underwent trans-esophageal echocardiography which again showed a moderate PFO with significant right-to-left shunting (Fig. 2).