Would love to see references/citations for this.  Intuitively, it could make sense, but I think you'd have to see *really* prolonged/protracted periods of time of increased PVR from crying (causing an increase in RA pressure and changing the atrial shunt to R --> L and that pressure inhibiting natural closure of the foramen ovale).  But I don't know.  Studying it could be difficult, especially if one had to rely on parental reports of crying -- and the vast majority of infants and later children and adults would never have an echocardiogram done to look for one anyway.

Am curious.

-Sarah Reece-Stremtan (peds anesthesiology fellow in Washington DC)

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