title: Platypnea-orthodeoxia syndrome: a diagnostic challenge.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Louisiana State University Health Sciences Center, Shreveport, LA 71103, USA. Desouza@seas.wustl.edu
authors.forename: Kavit A
authors.initials: KA
authors.lastname: Desouza
authors.forename: Shantanu
authors.initials: S
authors.lastname: Saraswat
authors.forename: Shilpa A
authors.initials: SA
authors.lastname: DeSouza
authors.forename: Venkataraman
authors.initials: V
authors.lastname: Rajaram
authors.forename: Pratap C
authors.initials: PC
authors.lastname: Reddy
authors.forename: Lawrence
authors.initials: L
authors.lastname: Mosley
authors.forename: Neeraj
authors.initials: N
authors.lastname: Tandon
mesh_terms: 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
chemical_list: D012711:Serum Albumin, Radio-Iodinated; D010100:Oxygen