title: Acute coronary syndrome and platypnoea-orthodeoxia with thoracic and interauricular septal aneurysms.
abstract: OBJECTIVE
  Platypnea-orthodeoxia is a rare syndrome characterized by dyspnea induced by the upright position and relieved by supine position and an arterial deoxygenation increased by the upright position which improves during recumbency. Several anatomical factors that can alter the atrial anatomy and facilitate shunting through an interatrial defect have been related to this syndrome. In many cases, this syndrome has been associated with patent foramen ovale (PFO) and right-to-left shunt. Rarely platypnea-orthodeoxia syndrome has been described associated with an aortic and with an interauricular septal aneurysm too.
  
  
  METHODS
  We present a case of platypnea-orthodeoxia syndrome in a 85-year-old woman with patent foramen ovale, interauricular septal aneurysm and ascending aortic aneurysms who was admitted for an acute coronary syndrome which could be of embolic origin and was responsible for ventricular fibrillation during the transfer to the hospital. PFO closure was performed by percutaneous device and right coronary artery obstruction was treated by transluminal angioplasty and stenting.
authors.affiliation: Critical Care Department, Department of Cardiology, Department of Pneumology; Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium. pascal.reper@chu-brugmann.be.
authors.forename: C
authors.initials: C
authors.lastname: Boudart
authors.forename: I
authors.initials: I
authors.lastname: Tabolcea
authors.forename: M
authors.initials: M
authors.lastname: Strachinaru
authors.forename: J
authors.initials: J
authors.lastname: Castro
authors.forename: A
authors.initials: A
authors.lastname: Noseda
authors.forename: P
authors.initials: P
authors.lastname: Gottignies
authors.forename: P
authors.initials: P
authors.lastname: Reper
mesh_terms: D054058:Acute Coronary Syndrome / Q000503:physiopathology*; D000369:Aged, 80 and over; D001011:Aorta / Q000503:physiopathology; D001014:Aortic Aneurysm / Q000503:physiopathology*; D054087:Atrial Septum / Q000503:physiopathology*; D004417:Dyspnea / Q000503:physiopathology*; D005260:Female; D054092:Foramen Ovale, Patent; D006322:Heart Aneurysm / Q000503:physiopathology*; D006801:Humans; D011187:Posture