title: [Platypnea-orthodeoxia syndrome, atrial septal aneurysm and right hemidiaphragmatic elevation with a right-to-left shunt through a patent foramen ovale].
abstract: Platypnea-orthodeoxia is an uncommon syndrome of dyspnea and hypoxemia induced by upright position, which is subsequently relieved by recumbency. The case reported involved a 75-year-old man with a seven days history of dyspnea in the upright position. The chest radiograph and CT scan demonstrated an elevated right hemidiaphragm. A surface echocardiogram with saline solution showed a patent foramen ovale (PFO) and atrial septal aneurysm. A pulmonary arteriogram was performed showing no evidence of pulmonary embolism and normal pulmonary arterial pressures. Later, he also developed dyspnea in the supine position and a transesophageal echocardiogram with contrast demonstrated a large right to left shunt through a PFO. The closure by a catheter-deployed double-umbrella device caused an immediate improvement in the patient's oxygenation.
authors.affiliation: División Terapia Intensiva, Policlínica Bancaria, Buenos Aires, Argentina. odlogaston@hotmail.com
authors.forename: Osvaldo D
authors.initials: OD
authors.lastname: Lopez Gaston
authors.forename: Oscar
authors.initials: O
authors.lastname: Calnevaro
authors.forename: Claudio
authors.initials: C
authors.lastname: Gallego
authors.forename: Jorge
authors.initials: J
authors.lastname: Bluguermann
authors.forename: David
authors.initials: D
authors.lastname: Barbieri
authors.forename: Miguel
authors.initials: M
authors.lastname: Granja
authors.forename: Diego
authors.initials: D
authors.lastname: Mc Loughlin
authors.forename: Eduardo
authors.initials: E
authors.lastname: Malvino
mesh_terms: D000368:Aged; D004417:Dyspnea / Q000209:etiology* / Q000503:physiopathology; D006322:Heart Aneurysm / Q000150:complications / Q000503:physiopathology*; D006344:Heart Septal Defects, Atrial / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D000860:Hypoxia / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D011187:Posture; D012133:Respiratory Paralysis / Q000150:complications*; D013577:Syndrome