title: An extreme case of platypnoea-orthodeoxia syndrome.
abstract: An 80-year-old female presented with progressive breathlessness, worse on sitting or standing and relieved by lying flat. Subsequent investigations identified a patent foramen ovale (PFO) with right-to-left flow across the interatrial septum (IAS). A diagnosis of platypnoea orthodeoxia syndrome secondary to inter-atrial shunting was made. Technical features precluded a percutaneous PFO closure so an open surgical repair was performed with complete resolution of symptoms. We discuss the pathophysiology and management of platypnoea orthodeoxia syndrome.
authors.affiliation: specialty registrar in interventional cardiology, King's College Hospital NHS Foundation Trust, London, UK drkogallagher@gmail.com.
authors.forename: Kevin
authors.initials: K
authors.lastname: O'Gallagher
authors.affiliation: medical student, King's College School of Medical Education, King's College London, London, UK.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Chou
authors.affiliation: medical student, King's College School of Medical Education, King's College London, London, UK.
authors.forename: Swarna
authors.initials: S
authors.lastname: Jeyabraba
authors.affiliation: senior house officer, King's College Hospital NHS Foundation Trust, London, UK.
authors.forename: Aish
authors.initials: A
authors.lastname: Sinha
authors.affiliation: consultant in cardiothoracic surgery, King's College Hospital NHS Foundation Trust, London, UK.
authors.forename: Daniel
authors.initials: D
authors.lastname: Robb
authors.affiliation: consultant cardiologist, King's College Hospital NHS Foundation Trust, London, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Byrne
mesh_terms: D000369:Aged, 80 and over; D004417:Dyspnea; D004452:Echocardiography; D005260:Female; D054092:Foramen Ovale, Patent; D006343:Heart Septal Defects; D006801:Humans; D000860:Hypoxia; D035583:Rare Diseases; D013577:Syndrome
keywords: Platypnoea; echocardiography; orthodeoxia