Stroke and Respiratory Failure: Mind the Shunt!
  • Diana Mano
    Centro Hospitalar e Universitário do Porto, Porto, Portugal
  • Patrícia Campos
    Centro Hospitalar e Universitário do Porto, Porto, Portugal
  • Bruno Vale
    Centro Hospitalar e Universitário do Porto, Porto, Portugal
  • Alexandre Pinto
    Centro Hospitalar e Universitário do Porto, Porto, Portugal


Ischaemic stroke, pulmonary shunt, paradoxical embolism, platypnoea-orthodeoxia syndrome


When stroke patients present with respiratory failure, the first thought that clinicians have is that it is probably related to aspiration pneumonia. However, other causes should be considered, such as intracardiac or intrapulmonary shunts, that could present with paradoxical embolism. Paradoxical embolism is a rare entity defined by the occurrence of a venous thrombotic event associated with a systemic arterial embolism. Frequently, paradoxical embolism presents with platypnoea-orthodeoxia syndrome. Platypnoea-orthodeoxia syndrome is uncommon and is characterized by dyspnoea and hypoxaemia induced by orthostatic position, where symptoms and oxygenation are relieved by recumbency. The authors report a case of a patient who presented with an ischaemic stroke and progression to platypnoea-orthodeoxia syndrome with documentation of simultaneous pulmonary embolism and pulmonary arteriovenous malformations.



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    Published: 2021-12-16
    Issue: 2021: Vol 8 No 12 (view)

    How to cite:
    Mano D, Campos P, Vale B, Pinto A. Stroke and Respiratory Failure: Mind the Shunt!. EJCRIM 2021;8 doi:10.12890/2021_003094.