• Enrico M Zardi, Silvia Spoto, Luciana Locorriere, Giulio Cacioli, Silvia Mazzaroppi, Bruno B Zobel, Germano Di Sciascio, and Sebastiano Costantino.
• 1 MD, PhD, Internal Medicine, Campus Bio-Medico University, Rome, Italy.
• Scot Med J. 2017 Aug 1; 62 (3): 122-125.

AbstractIntroduction Platypnea-orthodeoxia syndrome is a combination of positional dyspnoea and hypoxemia; it is caused by several cardiac, pulmonary and hepatic diseases. Case presentation In this study, we describe a 77-year-old female affected by unexplained dizziness and hypoxia that exacerbated in upright position. After diagnosing platypnea-orthodeoxia syndrome and excluding all possible causes (liver cirrhosis, acute and chronic pulmonary diseases and arteriovenous malformations), the origin of the syndrome was individuated in the presence of a patent foramen ovale with right-to-left shunt. Endovascular patent foramen ovale closure permitted the resolution of symptoms and disappearance of platypnea-orthodeoxia syndrome. Conclusion Although patent foramen ovale may be present since birth without giving clinical signs, it may represent a common enough cause of platypnea-orthodeoxia syndrome and other vascular complications in the elderly.

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