Two Cases of Platypnoea-Orthodexia

  • Laura Virginia Gonzalez Acute Medical Unit, Great Western Hospital, Swindon
  • Andrew Whitehead Acute Medical Unit, Great Western Hospital, Swindon


Platypnoea-orthodexia, hypoxia, shunt


Platypnoea-orthodexia syndrome is a rare cause of dyspnoea when hypoxaemia is induced by the upright position and relieved by recumbency. We report two cases in which platypnoea-orthodexia syndrome was present and caused by two different mechanisms: intracardiac shunt and intrapulmonary shunt.



  • Upadhyaya SGN, Ritchie AJ, Sarev T, Ryding A. If at first you do not succeed, think again! BMJ Case Rep 2012; doi:10.1136/bcr.12.2011.5442.

  • Altman M, Robin ED. Platypnea (diffuse zone I phenomenon?). N Engl J Med 1969;281:1347–1348.

  • Kubler P, Gibbs H, Garrahy P. Platypnoea-orthodeoxia syndrome. Heart 2000;83:221–223.

  • Hussain SF, Mekan SF. Platypnea-orthodeoxia: report of two cases and review of the literature. South Med J 2004;97:657–662.

  • Sanikommu V, Lasorda D, Poornima I. Anatomical factors triggering platypnea-orthodeoxia in adults. Clin Cardiol 2009;32:E55–57.

  • Marples IL, Heap MJ, Suvarna SK, Mills GH. Acute right-to-left inter-atrial shunt; an important cause of profound hypoxia. Br J Anaesth 2000;85:921–925.

  • Shakur R, Ryding A, Timperley J, Becher H, Leeson P. Late emergence of platypnea orthodeoxia: Chiari network and atrial septal hypertrophy demonstrated with transoesophageal echocardiography. Eur J Echocardiogr 2008;9:694–696.

  • Bourke SJ, Munro NC, White JE, Gibson GJ, Ashcroft T, Corris PA. Platypnoea-orthodeoxia in cryptogenic fibrosing alveolitis. Resp Med 1995;89:387–389.

  • Khan F, Parekh A. Reversible platypnea and orthodeoxia following recovery from adult respiratory distress syndrome. Chest 1979;75:526–528.

  • Legras A, Dequin PF, Hazouard E, Doucet O, Tranquart F, Perrotin D. Right-to-left interatrial shunt in ARDS: dramatic improvement in prone position. Intensive Care Med 1999;25:412–414.
  • Published: 2017-10-16

    Issue: Vol 4 No 10 (view)

    Section: Articles

    How to cite:
    Gonzalez, L., & Whitehead, A. (2017). Two Cases of Platypnoea-Orthodexia. European Journal of Case Reports in Internal Medicine, 4(10).