Platypnoea-orthodeoxia syndrome in the elderly: A difficult-to-make diagnosis of intracardiac right-to-left shunt

Introduction 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 upri...

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Bibliographic Details
Published in:Scottish medical journal 2017-08, Vol.62 (3), p.122-125
Main Authors: Zardi, Enrico M, Spoto, Silvia, Locorriere, Luciana, Cacioli, Giulio, Mazzaroppi, Silvia, Zobel, Bruno B, Di Sciascio, Germano, Costantino, Sebastiano
Format: Article
Language:English
Subjects:
Aged
Dyspnea - diagnostic imaging
Dyspnea - etiology
Dyspnea - surgery
Echocardiography, Transesophageal
Endovascular Procedures - methods
Female
Foramen Ovale, Patent - complications
Foramen Ovale, Patent - diagnostic imaging
Foramen Ovale, Patent - physiopathology
Heart Septal Defects - complications
Heart Septal Defects - diagnostic imaging
Heart Septal Defects - physiopathology
Heart Septal Defects - surgery
Humans
Hypoxia - diagnostic imaging
Hypoxia - etiology
Hypoxia - surgery
Male
Posture - physiology
Syndrome
Treatment Outcome
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Summary:Introduction 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.
ISSN:0036-9330
2045-6441
DOI:10.1177/0036933017727430