[A rare and curable cause of acute respiratory insufficiency after a pneumonectomy. The platypnea-orthodeoxia syndrome by the reopening of the foramen ovale].
We describe a case of a 54 year old patient who had developed a right to left shunt due to a patent foramen ovale as a late consequence of a pneumonectomy; this was responsible for acute respiratory insufficiency and respiratory failure. This is a rare complication, but its clinical presentation as platypnea-orthodeoxia should lead to the correct diagnosis. The diagnosis can be rapidly confirmed by a non-invasive examination, namely contrast echocardiography, coupled with color doppler. The treatment is surgical with excellent results. The pathophysiological mechanism is also discussed.
Darremont
O
O
Unité de Soins Intensifs de Pneumologie, CHR Nantes.
Ordronneau
J
J
Despins
P
P
Dabouis
G
G
Crochet
D
D
Lacroix
H
H
Chollet
S
S
Chailleux
E
E
D017023:Coronary Angiography; D004417:Dyspnea / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D004452:Echocardiography; D006344:Heart Septal Defects, Atrial / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D000860:Hypoxia / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D011187:Posture
Une cause rare et curable d'insuffisance respiratoire aiguë après pneumonectomie. Le syndrome de platypnée-orthodéoxie par réouverture du foramen ovale.