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Platypnoea-orthodeoxia is a relatively unknown syndrome characterized by dyspnoea and arterial desaturation during the transition from a lying to an uprighth position by right to left shunting of blood without increased blood pressure in the right atrium. The condition is assumed to be underdiagnosed because of challenging diagnostics. This case describes a woman who, despite extensive investigation, remained undiagnosed for years. The diagnosis should be kept in mind when treating unexplained desaturation.
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Eur Heart J Case Rep
February 2025
Department of Cardiology, Gifu Prefectural General Medical Center, 4-6-1, Noisshiki, Gifu 500-8717, Japan.
Background: Concurrent patent foramen ovale (PFO) and pulmonary arteriovenous malformation (PAVM) are rare but can cause paradoxical embolism and platypnoea-orthodeoxia syndrome (POS).
Case Summary: A 72-year-old female with embolic stroke history developed positional dyspnoea. Evaluation revealed right-to-left shunting through PFO and PAVM in the right middle lobe.
Intern Med J
April 2024
Department of Cardiology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
Platypnoea-orthodeoxia is a rare clinical syndrome characterised by dyspnoea and oxygen desaturation in the upright position which improves when supine. It requires two components: a sufficiently sized anatomical vascular defect (typically intra-cardiac or intra-pulmonary) combined with a functional component that promotes positional right-to-left shunting. We describe the rare occurrence of a patient with platypnoea-orthodeoxia syndrome (POS) because of a paradoxical shunt through a patent foramen ovale caused by a large right atrial line-associated thrombus in a male with metastatic oesophageal cancer undergoing chemotherapy.
View Article and Find Full Text PDFJ R Coll Physicians Edinb
June 2023
Russells Hall Hospital, Dudley, UK.
Platypnoea orthodeoxia syndrome is a rare condition, which can be present in patients with patent foramen ovale (PFO). In this case, a 72-year-old lady presented to the emergency department with a cryptogenic stroke associated with right thalamic infarct. While in hospital, it was noticed that the patient had desaturations in the upright position, and these improved in the recumbent position, consistent with platypnoea orthodeoxia syndrome.
View Article and Find Full Text PDFEur J Case Rep Intern Med
December 2021
Centro Hospitalar e Universitário do Porto, Porto, Portugal.
Unlabelled: When stroke patients present with respiratory failure, the first thought that clinicians have is that it is probably related to aspiration pneumonia. However, other causes should be considered, such as intracardiac or intrapulmonary shunts, that could present with paradoxical embolism. Paradoxical embolism is a rare entity defined by the occurrence of a venous thrombotic event associated with a systemic arterial embolism.
View Article and Find Full Text PDFEur J Case Rep Intern Med
October 2021
Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy.
Unlabelled: Platypnoea-orthodeoxia syndrome (POS) is a rare disorder and its pathophysiology has puzzled clinicians for years. Few cases of POS are described in COVID-19 patients in the literature, with a high variability of conditions related to the syndrome. In this article, we report the case of a patient admitted to our hospital for SARS-CoV-2 interstitial pneumonia, who developed POS during the hospitalization.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!