AI Article Synopsis
- An 85-year-old patient experienced palpitations and dyspnea, which improved when lying down, indicating a potential case of platypnea-orthodeoxia syndrome (POS).
- The diagnosis of POS was confirmed through repeated arterial oxygen saturation measurements in different positions, revealing a right-left shunt caused by a patent foramen ovale and related heart conditions.
- The POS was exacerbated by the patient's low blood volume from diarrhea and diuretics, and an unusual increase in oxygen saturation during hypertension highlighted how hemodynamic changes can influence the condition.
Article Abstract
We present the case of a 85-year-old patient admitted with palpitations and dyspnea. When assuming a recumbent position, we noticed a significant improvement in dyspnea, as well as a rise in arterial oxygen saturation. This is a typical presentation of platypnea-orthodeoxia syndrome (POS). The diagnosis was confirmed by serial analyses of the arterial oxygen saturation in different positions. In our patient, POS was caused by a cardiac right-left shunt through a patent foramen ovale, facilitated by an atrial septal aneurysm, a dilated aortic root and a large Eustachian valve. A low-volume state, caused by diarrhea and worsened by administration of diuretics in the emergency room, triggered the POS to become clinically apparent. We also noticed a rise in arterial oxygen saturation when the patient was in a hypertensive state. This has never been described before and underlines the influence of hemodynamic changes on the right-left shunt that underlies POS.
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| http://dx.doi.org/10.1080/17843286.2016.1196863 | DOI Listing |
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