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Case Reports
. 2015 Dec 8;187(18):1385-1388.
doi: 10.1503/cmaj.141525. Epub 2015 Jul 20.

Cardiac platypnea-orthodeoxia syndrome in a 73-year-old woman

Khai-Jing Ng  1 , Yi-Da Li  2
Affiliations
Case Reports

Cardiac platypnea-orthodeoxia syndrome in a 73-year-old woman

Khai-Jing Ng et al. CMAJ. .
No abstract available

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Figures

Figure 1:
Figure 1:
Bubble echocardiogram from a 73-year-old woman with progressive shortness of breath. Bubbles (asterisk) were seen in the left atrium (LA) and left ventricle (LV) within three cardiac cycles. We diagnosed platypnea-orthodeoxia syndrome.
Figure 2:
Figure 2:
Computed tomography showing the angle between the interatrial septum (solid line) and the sagittal axis (dotted line). The angle in our patient’s case measured 54.2° (A), whereas 25.4° is considered normal (B). The horizontal orientation of the atrial septum promotes a more direct pathway for venous blood flow, which may directly hit the interatrial septum and cause intracardiac shunting, even without a pressure gradient. LA = left atrium, LV = left ventricle, RA = right atrium.
Figure 3:
Figure 3:
Hemodynamic changes before and after the use of norepinephrine in a patient with platypnea-orthodeoxia syndrome. LA = left atrium, LV = left ventricle, RA = right atrium, RV = right ventricle.
See this image and copyright information in PMC

References

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    1. Cheng TO. Mechanisms of platypnea-orthodeoxia: What causes water to flow uphill? Circulation 2002;105:e47. - PubMed
    1. Kusunose K, Yamada H, Todoroki T, et al. Platypnea-orthodeoxia syndrome associated with patent foramen ovale and aortic ectasia. Echocardiography 2009;26:114–7. - PubMed
    1. Bertaux G, Eicher JC, Petit A, et al. Anotomic interaction between the aortic root and the atrial septum: a prospective echocardiographic study. J Am Soc Echocardiogr 2007;20:409–14. - PubMed

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