Patent foramen ovale presenting as platypnea-orthodeoxia: diagnosis by transesophageal echocardiography.
Platypnea-orthodeoxia is a rare syndrome that is often associated with interatrial shunting through a patent foramen ovale or atrial septal defect. We describe the case of a 65-year-old woman with progressive dyspnea and hypoxia when standing and walking, which was relieved by assuming the recumbent position. The diagnosis was confirmed by tilt-table transesophageal echocardiography demonstrating a large right-to-left shunt through a patent foramen ovale while the patient was in a semiupright position and no significant shunt while in a recumbent position. This case demonstrates that platypnea-orthodeoxia caused by a patent foramen ovale can be clearly demonstrated by the technique of contrast transesophageal echocardiography performed on a tilt table.
Roxas-Timonera
M
M
Department of Medicine, Division of Cardiology, Columbia University, New York, NY, USA.
Larracas
C
C
Gersony
D
D
Di Tullio
M
M
Keller
A
A
Homma
S
S
D000368:Aged; D003937:Diagnosis, Differential; D004417:Dyspnea / Q000209:etiology; D017548:Echocardiography, Transesophageal; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications* / Q000000981:diagnostic imaging*; D006801:Humans; D000860:Hypoxia / Q000209:etiology; D011187:Posture; D012133:Respiratory Paralysis / Q000209:etiology