Platypnea-orthodeoxia syndrome: a diagnostic challenge.
Platypnea-orthodeoxia (P-O) syndrome is an underdiagnosed condition characterized by dyspnea and deoxygenation accompanying a change from a recumbent to an upright position. It is caused by increased right-to-left shunting of blood on assuming an upright position. The diagnosis of this shunt is often challenging. A case where a diagnosis was missed despite performing a tilt transesophageal echocardiogram with bubble study and a technetium labeled macroaggregated albumin scan is presented. However, a large patent foramen ovale (PFO) was found on autopsy. A brief overview of the diagnostic workup and management of this condition along with methods to increase the sensitivity of diagnostic tests is discussed.
Desouza
Kavit A
KA
Department of Internal Medicine, Louisiana State University Health Sciences Center, Shreveport, LA 71103, USA. Desouza@seas.wustl.edu
Saraswat
Shantanu
S
DeSouza
Shilpa A
SA
Rajaram
Venkataraman
V
Reddy
Pratap C
PC
Mosley
Lawrence
L
Tandon
Neeraj
N
D000369:Aged, 80 and over; D004417:Dyspnea / Q000209:etiology*; D004452:Echocardiography; D017809:Fatal Outcome; D054092:Foramen Ovale, Patent / Q000473:pathology*; D006801:Humans; D008297:Male; D010092:Oximetry; D010100:Oxygen / Q000008:administration & dosage / Q000097:blood*; D011187:Posture; D012711:Serum Albumin, Radio-Iodinated; D013577:Syndrome
D012711:Serum Albumin, Radio-Iodinated; D010100:Oxygen