title: Platypnea-Orthodeoxia Syndrome: A Case of Chronic Paroxysmal Hypoxemia.
abstract: A 75-year-old man with chronic (30-year) unexplained paroxysmal hypoxemia presented with postural hypoxemia and desaturation consistent with a clinical manifestation of platypnea-orthodeoxia syndrome. His history included a lack of significant past pulmonary disease, yet with intermittent need for oxygen supplementation. On admission he was found to have an interatrial shunt through a patent foramen ovale. Device closure by percutaneous catheterization led to sustained resolution of symptoms. Platypnea-orthodeoxia syndrome is a rare but important consideration in the differential diagnosis of hypoxemia, as it represents a potentially curable cause of hypoxemia, with missed diagnosis leading to possible patient morbidity if untreated. Even more importantly, an astute and careful history and physical examination are integral to the diagnosis of this rare but likely under-recognized syndrome.
authors: School of Medicine, Oregon Health & Science University, Portland, OR, USA.|Oregon Health & Science University, 3181 SW Sam Jackson Park Road Mail Code: BTE119, Portland, OR, 97239, USA.
authors: C Craig
authors: CC
authors: Rudy
authors: The Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA.|Oregon Health & Science University, 3181 SW Sam Jackson Park Road Mail Code: BTE119, Portland, OR, 97239, USA.
authors: Cody
authors: C
authors: Ballard
authors: The Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA.|Oregon Health & Science University, 3181 SW Sam Jackson Park Road Mail Code: BTE119, Portland, OR, 97239, USA.
authors: Craig
authors: C
authors: Broberg
authors: Division of Hospital Medicine, Department of Medicine, Oregon Health & Science University, Portland, OR, USA. huntera@ohsu.edu.|Oregon Health & Science University, 3181 SW Sam Jackson Park Road Mail Code: BTE119, Portland, OR, 97239, USA. huntera@ohsu.edu.
authors: Alan J
authors: AJ
authors: Hunter
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D004418:Dyspnea, Paroxysmal / Q000150:complications / Q000503:physiopathology*; D017548:Echocardiography, Transesophageal; D054085:Foramen Ovale / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D000860:Hypoxia / Q000150:complications / Q000503:physiopathology*; D008297:Male; D011187:Posture; D013577:Syndrome
keywords: hypoxemia; intracardiac shunt; orthodeoxia; patent foramen ovale; platypnea