This report describes a patient with a massive right ventricular infarction, complicated by severe hypoxemia. Contrast echocardiography demonstrated a right to left shunt through a previously asymptomatic atrial septal defect. This phenomenon should be considered as a possible cause of hypoxemia in the presence of right ventricular infarction.

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Journal Journal of the American College of Cardiology
Rietveld, A.P, Merrman, L. (Leo), Essed, C.E, Trimbos, J.B.M.J. (Jan B.M.J.), & Hagemeijer, F. (Frans). (1983). Right to left shunt, with severe hypoxemia, at the atrial level in a patient with hemodynamically important right ventricular infarction. Journal of the American College of Cardiology, 2(4), 776–779. doi:10.1016/S0735-1097(83)80319-2