Platypnoea and orthodeoxia in the hepatopulmonary syndrome.

BMJ Case Rep

Acute Medicine Department, Northumbria Healthcare NHS Foundation Trust, Newcastle Upon Tyne, UK

Published: November 2019

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Article Abstract

A 71-year-old female patient with alcohol-induced cirrhosis presented with symptoms of dyspnoea. Previous extensive investigations had detected no apparent cause. Platypnoea and orthodeoxia were observed. A bubble echocardiogram revealed significant intracardiac shunting and a diagnosis of hepatopulmonary syndrome was made. The patient was discharged on home oxygen and referred for liver transplantation.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6887442PMC
http://dx.doi.org/10.1136/bcr-2019-231499DOI Listing

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Platypnea-orthodeoxia syndrome (POS) is characterized by dyspnea due to a marked fall in blood oxygen saturation while assuming standing or sitting positions. It is a rare condition with an unknown prevalence. The triggering role may remain unclear in a considerable number of patients.

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Article Synopsis
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Platypnea-orthodeoxia syndrome (POS) is a rare clinical entity characterized by the onset of dyspnea and hypoxemia that normally manifests in the upright position, improving with recumbency. POS is generally caused by both anatomical and functional defects that lead to a right-to-left shunt. Herein, we present an illustrative case of POS in an elderly patient admitted for severe hypoxemia, in which a massive right-to-left shunt through a patent foramen ovale facilitated by an anatomic disturbance was found.

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Article Synopsis
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