Platypnea-Orthodeoxia: A Case of Unexplained Hypoxia. WMJ 2018 Oct;117(4):175-176
Date
11/09/2018Pubmed ID
30407770Scopus ID
2-s2.0-85056386796 (requires institutional sign-in at Scopus site) 1 CitationAbstract
INTRODUCTION: Platypnea-orthodeoxia syndrome is a rare clinical syndrome defined by worsening deoxygenation and dyspnea when changing to an upright sitting or standing position. It is seen in 3 different clinical scenarios: intracardiac shunts, pulmonary arteriovenous shunts, and ventilation/perfusion mismatch in the lungs.
CASE: An 82-year-old woman with a history of nonischemic cardiomyopathy with reduced ejection fraction was admitted with dyspnea and hypoxemia. She was found to have atrial septal defect with right to left shunting in the setting of normal right atrial pressures.
DISCUSSION: Platypnea-orthodeoxia syndrome is a clinical syndrome where, in the setting of an interatrial communication, a right to left shunt can occur without elevated pulmonary or right atrial pressure, resulting in significant hypoxia.
CONCLUSION: Platypnea-orthodeoxia syndrome is a clinical condition that is being recognized more frequently due to more accurate diagnosis, and its treatment can alleviate symptomatic hypoxemia.
Author List
Marzlin N, Dunbar S, Cinquegrani MAuthor
Michael P. Cinquegrani MD Director, Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Aged, 80 and overDiagnosis, Differential
Dyspnea
Female
Heart Septal Defects, Atrial
Humans
Hypoxia
Posture
Septal Occluder Device
Syndrome