[Platypnea-orthodeoxia syndrome, atrial septal aneurysm and

Medicina · Jan 2005

Case Reports

[Platypnea-orthodeoxia syndrome, atrial septal aneurysm and right hemidiaphragmatic elevation with a right-to-left shunt through a patent foramen ovale].

Platypnea-orthodeoxia is an uncommon syndrome of dyspnea and hypoxemia induced by upright position, which is subsequently relieved by recumbency. The case reported involved a 75-year-old man with a seven days history of dyspnea in the upright position. The chest radiograph and CT scan demonstrated an elevated right hemidiaphragm. ⋯ A pulmonary arteriogram was performed showing no evidence of pulmonary embolism and normal pulmonary arterial pressures. Later, he also developed dyspnea in the supine position and a transesophageal echocardiogram with contrast demonstrated a large right to left shunt through a PFO. The closure by a catheter-deployed double-umbrella device caused an immediate improvement in the patient's oxygenation.

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- Osvaldo D Lopez Gaston, Oscar Calnevaro, Claudio Gallego, Jorge Bluguermann, David Barbieri, Miguel Granja, Diego Mc Loughlin, and Eduardo Malvino.
- División Terapia Intensiva, Policlínica Bancaria, Buenos Aires, Argentina. odlogaston@hotmail.com
- Medicina (B Aires). 2005 Jan 1;65(3):252-4.
AbstractPlatypnea-orthodeoxia is an uncommon syndrome of dyspnea and hypoxemia induced by upright position, which is subsequently relieved by recumbency. The case reported involved a 75-year-old man with a seven days history of dyspnea in the upright position. The chest radiograph and CT scan demonstrated an elevated right hemidiaphragm. A surface echocardiogram with saline solution showed a patent foramen ovale (PFO) and atrial septal aneurysm. A pulmonary arteriogram was performed showing no evidence of pulmonary embolism and normal pulmonary arterial pressures. Later, he also developed dyspnea in the supine position and a transesophageal echocardiogram with contrast demonstrated a large right to left shunt through a PFO. The closure by a catheter-deployed double-umbrella device caused an immediate improvement in the patient's oxygenation.

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[Platypnea-orthodeoxia syndrome, atrial septal aneurysm and right hemidiaphragmatic elevation with a right-to-left shunt through a patent foramen ovale].

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