• Internal medicine · May 2023

    Case Reports

    Usefulness of a Pulse Oximeter and Multimodality Imaging for Diagnosing Platypnea-orthodeoxia Syndrome.

    • Ryo Abe, Mike Saji, Yuki Izumi, Itaru Takamisawa, Kanako Kishiki, Satonori Maekawara, Yuji Nagatomo, Satoshi Yazaki, Mamoru Nanasato, and Mitsuaki Isobe.
    • Department of Cardiology, Sakakibara Heart Institute, Japan.
    • Intern. Med. 2023 May 1; 62 (9): 130513091305-1309.

    AbstractPlatypnea-orthodeoxia syndrome (POS) is a rare disease characterized by dyspnea and hypoxemia in orthostatism that improves in the recumbent position. We herein report an 81-year-old woman with dyspnea in the upright position following thoracic vertebral compression fractures. After the patient's daughter brought a recording showing decreasing SpO2 (peripheral capillary oxygen saturation) in the upright position as measured by a portable pulse oximeter outside the hospital, a small atrial septal defect (ASD) was detected. A contrast echocardiogram and four-dimensional flow magnetic resonance imaging demonstrated a right-to-left shunt. The patient's symptoms dramatically improved after percutaneous ASD closure. In conclusion, such new technologies are useful for diagnosing POS.

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