LinksRechtsShunt

LinksRechtsShunt is a term used in German-language medical literature to describe a left-to-right shunt in the cardiovascular system. It refers to abnormal blood flow from the left (systemic) side of the heart or circulation to the right (pulmonary) side, resulting in increased pulmonary blood flow and potential volume overload of the right heart.

Mechanism and implications: The shunt arises from defects or connections that permit blood to bypass the normal routing through the left-sided circuit. The hemodynamic effect is quantified by the ratio of pulmonary to systemic blood flow (Qp:Qs), with ratios greater than 1 indicating a left-to-right shunt. Persistent, sizable shunts can lead to pulmonary overcirculation, right heart dilation, and, if untreated, pulmonary hypertension and heart failure.

Common causes: Atrial septal defect (ASD), ventricular septal defect (VSD), patent ductus arteriosus (PDA), and certain anomalous venous connections can produce a left-to-right shunt. The term encompasses a range of congenital and acquired conditions that create an abnormal left-to-right flow without immediately compromising systemic oxygenation.

Diagnosis and management: Diagnosis typically relies on echocardiography to visualize defects and estimate shunt magnitude, supplemented by cardiac MRI or CT as needed and, in some cases, cardiac catheterization to measure hemodynamics and determine Qp:Qs. Treatment decisions depend on shunt size, symptoms, and patient age; small defects may be observed, while significant shunts are often treated with surgical repair or transcatheter device closure (for example, ASD, VSD, or PDA closure).

Etymology and usage: The term combines German terms for left and right (Links and Rechts) with the English medical term shunt. It overlaps with the broader concept of left-to-right shunts in cardiology literature. See also: left-to-right shunt, right-to-left shunt.