Platypnea-Orthodeoxia Syndrome: Diagnostic Challenge and the Importance of Heightened Clinical Suspicion.
Platypnea-orthodeoxia syndrome is an uncommon condition of positional dyspnea and hypoxemia; symptoms occur when the patient is upright and resolve with recumbency. Causes can be broadly categorized into 4 groups: intracardiac shunting, pulmonary shunting, ventilation-perfusion mismatch, or a combination of these. Platypnea-orthodeoxia syndrome should be suspected when normal arterial oxygen saturations are recorded while an individual is supine, followed by abrupt declines in those saturations when upright. Further investigations with use of imaging and cardiac catheterization aid in the evaluation. When platypnea-orthodeoxia syndrome is due to intracardiac shunting without pulmonary hypertension, intracardiac shunt closure can be curative. In this article, we report a case of platypnea-orthodeoxia syndrome in an 83-year-old woman who was successfully treated by means of percutaneous transcatheter closure of an atrial septal defect.
Stanislav
S
Henkin
Sara
S
Negrotto
Peter M
PM
Pollak
Michael W
MW
Cullen
D Fearghas
DF
O'Cochlain
R Scott
RS
Wright
D000369:Aged, 80 and over; D006328:Cardiac Catheterization / Q000295:instrumentation; D004417:Dyspnea / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D006439:Hemodynamics; D006801:Humans; D000860:Hypoxia / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D008955:Models, Cardiovascular; D056888:Patient Positioning; D011187:Posture; D011237:Predictive Value of Tests; D055989:Septal Occluder Device; D016683:Supine Position; D013577:Syndrome; D016896:Treatment Outcome
Aged, 80 and over; atrial septal defect; cardiac platypnea-orthodeoxia syndrome; dyspnea/etiology/physiopathology; foramen ovale, patent; heart septal defects, atrial/complications; oxygen/blood; posture/physiology; septal occluder device; supine position