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Case Reports
. 2021 Apr 19;21(1):126.
doi: 10.1186/s12890-021-01494-7.

Patent foramen ovale revealed by COVID-19 pneumonia

Charlotte Vanhomwegen  1 , Olivier Taton  2 , Nicolas Selvais  3 , Olivier Vanhove  2 , Dimitri Leduc  2
Affiliations
Case Reports

Patent foramen ovale revealed by COVID-19 pneumonia

Charlotte Vanhomwegen et al. BMC Pulm Med. .

Abstract

Background: Platypnea-orthodeoxia syndrome (POS) is a rare condition characterized by dyspnoea (platypnea) and arterial desaturation in the upright position resolved in the supine position (orthodeoxia). Intracardiac shunt, pulmonary ventilation-perfusion mismatch and others intrapulmonary abnormalities are involved.

Case presentation: We report a case of POS associated with two pathophysiological issues: one, cardiac POS caused by a patent foramen ovale (PFO) and second, pulmonary POS due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) interstitial pneumonia. POS has resolved after recovery of coronavirus disease 2019 (COVID-19) pneumonia.

Conclusions: Right-to-left interatrial shunt and intrapulmonary shunt caused by SARS-CoV-2 pneumonia contributed to refractory hypoxemia and POS. Therefore, in case of COVID-19 patient with unexplained POS, the existence of PFO must be investigated.

Keywords: Hypoxemia; Patent foramen ovale; Pulmonary vasoconstriction; SARS-CoV-2; Ventilation inhomogeneity.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
CT scan on admission. a Bilateral ground glass opacities predominantly with a peripheral lung distribution. b Crazy paving pattern in the right middle lobe and in the inferior lobes bilaterally
Fig. 2
Fig. 2
CT scan after 2 weeks of hospitalisation. In comparison with the initial CT scan, ground glass opacities have been replaced by much more extensive consolidation lesions, especially predominant at the bases. Majoration of bilateral consolidations present in the middle and inferior lobes
Fig. 3
Fig. 3
Bubble contrast echocardiography. Two-dimensional transthoracic echocardiography image showing a right-to-left shunt upon release of the Valsalva maneuver
See this image and copyright information in PMC

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