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[Platypnea-orthodeoxia syndrome in a patient with heart failure: A case report].

Rev Med Interne

December 2024

Service de pathologies cardiovasculaires, hôpital d'instruction des armées Laveran, 34, boulevard Laveran, CS 50004, 13384 Marseille, France.

Introduction: The platypnea orthodeoxia syndrome is a rare clinical entity combining positional dyspnea and arterial oxygen desaturation during the transition to orthostatism, reversible on return to decubitus. The most frequent etiology of this syndrome is the presence of a patent foramen ovale (PFO) responsible for a right-to-left intracardiac shunt, the severity of which results in significant functional disability and a risk of death from hypoxia.

Case Report: We report the case of a 93-year old patient on long-term oxygen, initially hospitalized for acute heart failure following a community-acquired urinary tract infection.

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Introduction: Mitral regurgitation is a potential complication of transcatheter aortic valve replacement. Here, we report a case of severe acute mitral regurgitation caused by papillary muscle rupture occurring 16 days after transcatheter aortic valve replacement.

Presentation Of Case: An 82-year-old woman with severe AS was referred to our hospital.

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Surveillance imaging at 45 to 90 days after transcatheter left atrial appendage occlusion device implantation with transesophageal echocardiography (TEE) or cardiac computed tomography (CT) is recommended to assess device position and the presence of device-related complications such as device-related thrombus (DRT) or peridevice leak. Detection of DRT is associated with a significantly increased risk of a stroke or systemic embolization event within 6 months of detection. Nonetheless, there is significant variability in detection of DRT as a result of timing, frequency, and imaging modality used for surveillance.

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Infective endocarditis is rare but carries significant morbidity, including risk of systemic embolization. A 67-year-old woman presented with endocarditis. Evaluation revealed a mobile mitral valve vegetation and a right atrial mass.

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Article Synopsis
  • Cor Triatriatum Dexter (CTD) is a rare heart defect that splits the right atrium into two chambers, with a milder version called incomplete CTD (CTDi) that only partially divides it.
  • CTDi can be linked to interatrial septal defects and often presents in adults who experience cryptogenic strokes, usually leading to referrals for closure of a patent foramen ovale (PFO).
  • Successful PFO closure in patients with CTDi can be challenging due to complications in visualization and device deployment, making advanced imaging techniques and careful planning essential for positive outcomes.
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