Platypnoea-Orthodeoxia Syndrome: An Intriguing Diagnosis

  • Vânia Rodrigues Internal Medicine Department, Centro Hospitalar de Leiria, Leiria, Portugal
  • Tiago Gomes Dermatology Department, Centro Hospitalar de Leiria, Leiria, Portugal
  • Adriana Santos Silva Internal Medicine Department, Centro Hospitalar de Leiria, Leiria, Portugal
  • Rita Rocha Internal Medicine Department, Centro Hospitalar de Leiria, Leiria, Portugal
  • Ana Ferrão Internal Medicine Department, Centro Hospitalar de Leiria, Leiria, Portugal

Keywords

Hypoxaemia, patent foramen ovale, dyspnoea, platypnoea-orthodeoxia

Abstract

Platypnoea-orthodeoxia syndrome (POS) is an uncommon clinical entity characterized by dyspnoea and hypoxaemia induced by upright posture and relieved by recumbence. It is often associated with right-to-left shunting through a patent foramen ovale (PFO) or an atrial septal defect. We report the case of a 79-year-old woman with hypoxaemia initially attributed to a pulmonary infection but persisting after successful treatment. Being in the upright position triggered the hypoxaemia. A thoracic CT angiogram and ventilation/perfusion lung scan excluded a pulmonary embolism, but a transoesophageal echocardiogram with a bubble test showed a PFO with a right-to-left shunt, without pulmonary hypertension. The patient underwent percutaneous closure of the PFO which led to prompt symptom relief and full functional recovery.

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  • Published: 2019-02-22

    Issue: Vol 6 No 2 (view)

    Section: Articles

    How to cite:
    Rodrigues, V., Gomes, T., Santos Silva, A., Rocha, R., & Ferrão, A. (2019). Platypnoea-Orthodeoxia Syndrome: An Intriguing Diagnosis. European Journal of Case Reports in Internal Medicine, 6(2). https://doi.org/https://doi.org/10.12890/2019_001030

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