Platypnea-orthodeoxia related to aortic elongation.
An 80-year-old woman presented with progressive shortness of breath. There was no history of pulmonary or cardiac disease. Results of a physical examination were normal. She had significant oxygen desaturation while she was in an upright position. Admission to the hospital for workup followed, and evaluation included tilt-table transesophageal echocardiogram and cardiac catheterization. A massive right-to-left shunt through a patent foramen ovale was detected, and surgical intervention resulted in dramatic improvement of symptoms. In this patient, it seems that the syndrome of platypnea-orthodeoxia was related to aortic elongation, allowing significant right-to-left shunt.
Popp
G
G
Department of Internal Medicine, Eastern Virginia Medical School, Norfolk, USA.
Melek
H
H
Garnett
A R
AR
D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic; D001018:Aortic Diseases / Q000150:complications* / Q000175:diagnosis / Q000209:etiology; D003937:Diagnosis, Differential; D004417:Dyspnea / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000175:diagnosis; D006801:Humans; D000860:Hypoxia / Q000175:diagnosis / Q000209:etiology*; D011187:Posture; D013577:Syndrome