Orthodeoxia and platypnea secondary to a patent foramen ovale despite normal right-sided cardiac pressures.
Numerous cases of orthodeoxia and platypnea have been reported. Some have been found to be due to intracardiac shunts despite normal intracardiac pressures. In the case presented, a 79-year-old woman was noted to have orthodeoxia and platypnea secondary to a patent foramen ovale (PFO) despite normal intracardiac pressures. She recovered after closure of the PFO. The authors postulate that recent vertebral fractures and subsequent kyphosis, as well as a dilated thoracic aorta, altered intrathoracic relationships and may have led to a stream of venous return being directed across the PFO in the upright position, despite normal intracardiac pressures.
Varkul
M
M
Department of Medicine, University of Toronto, Ontario, Canada.
Robinson
T
T
Ng
E
E
Hyland
R
R
D000368:Aged; D001013:Aorta, Thoracic / Q000503:physiopathology; D004417:Dyspnea / Q000209:etiology*; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D000860:Hypoxia / Q000209:etiology*; D007738:Kyphosis / Q000150:complications / Q000000981:diagnostic imaging; D011187:Posture; D011859:Radiography; D016103:Spinal Fractures / Q000150:complications / Q000000981:diagnostic imaging; D017725:Ventricular Pressure