• Vânia Rodrigues, Tiago Fernandes Gomes, Adriana Santos Silva, Rita Rocha, and Ana Ferrão.
• Internal Medicine Department, Centro Hospitalar de Leiria, Leiria, Portugal.
• Eur J Case Rep Intern Med. 2019 Jan 1; 6 (2): 001030.

AbstractPlatypnoea-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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