[Platypnea-orthodeoxia of a 69-year old woman with a patent foramen ovale].
Platypnea-orthodeoxia is a rare syndrome that is often associated with interatrial shunting through a patent foramen ovale (PFO) or atrial septal defect. We describe the case of a 69-year-old woman with progressive dyspnea and hypoxia when standing, which was relieved by assuming the recumbent position. After detection of a PFO by transesophageal echocardiography the diagnosis was confirmed by transthoracic echocardiography using saline contrast injection while lying supine and standing upright. This maneuver demonstrated a large right-to-left shunt through a patent foramen ovale while the patient was in a upright position and no significant shunt while being in a recumbent position. The patient showed a rapid improvement after closure of the PFO. This case demonstrates that platypnea-orthodeoxia caused by a patent foramen ovale can be easily demonstrated by the technique of contrast transthoracic echocardiography and a simple positioning maneuver.
Dogu
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Kardiologische Abteilung des Zentralkrankenhauses, Links der Weser, Senator-Wessling-Strasse 1, 28277 Bremen, Germany.
Stöhr
A
A
Zick-Bögemann
R
R
Hegeler-Molkewehrum
C
C
Hartmann
H
H
Engel
H J
HJ
D000368:Aged; D004417:Dyspnea / Q000000981:diagnostic imaging*; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging*; D006801:Humans; D000860:Hypoxia / Q000000981:diagnostic imaging*; D011187:Posture; D013577:Syndrome