• Henning Dopp, Markus Kröll, and Axel Meissner.
• Medizinische Klinik II, Klinik für Kardiologie, Rhythmologie und internistische Intensivmedizin, Klinikum Köln-Merheim, Universität Witten-Herdecke, Köln.
• Dtsch. Med. Wochenschr. 2020 May 1; 145 (9): 619-623.

History And Clinicial FindingsWe elaborate a case of a 79-year-old patient who presented with position dependent shortness of breath and cyanosis of the lips at the daily round.InvestigationsIn supine position the patient's oxygen saturation was normal > 95 %, in upright position we noticed a reproducible decrease to 76-85 %. Echocardiographic examination revealed a patent foramen ovale (PFO) with spontaneous right-left shunt and additionally a thoracic aortic aneurysm.DiagnosisDue to a typical position dependent cyanosis, dyspnea and decreased oxygen saturation in combination with patent foramen ovale and aortic aneurysm, Platypnea-Orthodeoxia Syndrome was our suspected diagnosis.Treatment And CourseAfter percutaneously occlusion of the foramen ovale the patient presented symptom-free und oxygen saturation remained stable in supine and upright positions. In the follow up examination a significant right-left shunt could no longer be found.ConclusionThe combination of position dependent shortness of breath and decreased oxygen saturation should lead to the diagnosis of Platypnea-Orthodeoxia Syndrome. The underlying reasons are diverse and not only of cardiologic origin.© Georg Thieme Verlag KG Stuttgart · New York.

23 keywords...

hide…