Kok Chin Chong

Atypical CTPA contrast timing revealing a suspected right-to-left shunt in a patient with advanced COPD and concurrent pulmonary malignancy

Hypoxemia in chronic obstructive pulmonary disease (COPD) typically arises from ventilation-perfusion (V/Q) mismatch. However, refractory hypoxemia should raise concern for alternative mechanisms, such as intracardiac shunting. This report describes a rare presentation where a ca...