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.
Learning Points: Platypnoea-orthodeoxia syndrome (POS) is a possible and rare condition associated with SARS-CoV-2 pneumonia.A prompt diagnosis of POS is important in order to start careful and adequate oxygen supplementation.Clinical data on COVID-19 evolution in patients with POS and possible therapeutic and rehabilitative strategies are not available in the literature.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8592651 | PMC |
http://dx.doi.org/10.12890/2021_002849 | DOI Listing |
Singapore Med J
September 2024
Rehabilitation Medicine Department, Tan Tock Seng Hospital, Singapore.
Introduction: Platypnoea-orthodeoxia syndrome (POS) is an uncommon clinical entity characterised by dyspnoea and platypnoea (oxygen desaturation that follows the assumption of an upright position from recumbency). Since the coronavirus disease 2019 (COVID-19) outbreak, increasing reports of COVID-19-related POS and its associated morbidity have been reported around the world. We aimed to study the characteristics of COVID-19-related POS and orthodeoxia (including associations leading to a more prolonged orthodeoxia), and the postdischarge functional outcomes of patients with COVID-19-related POS.
View Article and Find Full Text PDFIntern 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 PDFRespir Investig
March 2024
Department of Rehabilitation Medicine, Nagasaki University Hospital, Nagasaki, Japan; Department of Physical Therapy Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
This retrospective observational study aimed to assess the clinical characteristics of platypnea-orthodeoxia syndrome in patients with coronavirus disease 2019 (COVID-19) treated using mechanical ventilation or high-flow nasal canula. We analyzed 42 consecutive patients with COVID-19 from January 2020 to March 2022. The primary outcomes were the incidence of platypnea-orthodeoxia syndrome, the time with required long-term oxygen therapy, and short-term prognosis.
View Article and Find Full Text PDFBMJ Case Rep
October 2023
Pulmonary Medicine, Christian Medical College, Vellore, Tamil Nadu, India.
Platypnoea-orthodeoxia syndrome is characterised by dyspnoea and oxygen desaturation in the upright position usually caused by an extracardiac shunt and less often due to dynamic factors that accentuate an intracardiac right-to-left shunt. In our patient, the collapse of lower lobe of left lung secondary to bronchial stenosis due to endobronchial tuberculosis and resultant mediastinal shift was the factor that led to an otherwise unrecognised intracardiac right-to-left shunt leading to platypnoea-orthodeoxia. We postulate that there would have been an increased stretching and widening of a patent foramen ovale in the upright position due to gravity resulting in an increased shunt despite normal intracardiac pressures.
View Article and Find Full Text PDFEur Heart J Cardiovasc Imaging
January 2024
Division of Cardiology, Department of Internal Medicine, Jeonbuk National University Medical School, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju 54907, Republic of Korea.
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