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Case Reports
. 2015 Oct 1;42(5):498-501.
doi: 10.14503/THIJ-14-4596. eCollection 2015 Oct.

Platypnea-Orthodeoxia Syndrome: Diagnostic Challenge and the Importance of Heightened Clinical Suspicion

Stanislav Henkin, Sara Negrotto, Peter M Pollak, Michael W Cullen, D Fearghas O'Cochlain, R Scott Wright
Case Reports

Platypnea-Orthodeoxia Syndrome: Diagnostic Challenge and the Importance of Heightened Clinical Suspicion

Stanislav Henkin et al. Tex Heart Inst J. .

Abstract

Platypnea-orthodeoxia syndrome is an uncommon condition of positional dyspnea and hypoxemia; symptoms occur when the patient is upright and resolve with recumbency. Causes can be broadly categorized into 4 groups: intracardiac shunting, pulmonary shunting, ventilation-perfusion mismatch, or a combination of these. Platypnea-orthodeoxia syndrome should be suspected when normal arterial oxygen saturations are recorded while an individual is supine, followed by abrupt declines in those saturations when upright. Further investigations with use of imaging and cardiac catheterization aid in the evaluation. When platypnea-orthodeoxia syndrome is due to intracardiac shunting without pulmonary hypertension, intracardiac shunt closure can be curative. In this article, we report a case of platypnea-orthodeoxia syndrome in an 83-year-old woman who was successfully treated by means of percutaneous transcatheter closure of an atrial septal defect.

Keywords: Aged, 80 and over; atrial septal defect; cardiac platypnea-orthodeoxia syndrome; dyspnea/etiology/physiopathology; foramen ovale, patent; heart septal defects, atrial/complications; oxygen/blood; posture/physiology; septal occluder device; supine position.

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Figures

Fig. 1.
Fig. 1.
Transesophageal color-flow Doppler echocardiogram shows a secundum atrial septal defect of moderate size.
See this image and copyright information in PMC

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