Platypnea-Orthodeoxia Syndrome: Diagnostic Challenge and the Importance of Heightened Clinical Suspicion

Platypnea-orthodeoxia syndrome is an uncommon condition of positional dyspnea and hypoxemia; symptoms occur when the patient is upright and resolve with recumbency. Causes can be broadly categorized into 4 groups: intracardiac shunting, pulmonary shunting, ventilation-perfusion mismatch, or a combin...

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Bibliographic Details
Published in:Texas Heart Institute journal 2015-10, Vol.42 (5), p.498-501
Main Authors: Henkin, Stanislav, Negrotto, Sara, Pollak, Peter M, Cullen, Michael W, O'Cochlain, D Fearghas, Wright, R Scott
Format: Article
Language:English
Subjects:
Aged, 80 and over
Cardiac Catheterization - instrumentation
Case Reports
Dyspnea - diagnosis
Dyspnea - etiology
Dyspnea - physiopathology
Dyspnea - therapy
Echocardiography, Doppler, Color
Echocardiography, Transesophageal
Female
Heart Septal Defects, Atrial - complications
Heart Septal Defects, Atrial - diagnosis
Heart Septal Defects, Atrial - therapy
Hemodynamics
Humans
Hypoxia - diagnosis
Hypoxia - etiology
Hypoxia - physiopathology
Hypoxia - therapy
Models, Cardiovascular
Patient Positioning
Posture
Predictive Value of Tests
Septal Occluder Device
Supine Position
Syndrome
Treatment Outcome
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Summary:Platypnea-orthodeoxia syndrome is an uncommon condition of positional dyspnea and hypoxemia; symptoms occur when the patient is upright and resolve with recumbency. Causes can be broadly categorized into 4 groups: intracardiac shunting, pulmonary shunting, ventilation-perfusion mismatch, or a combination of these. Platypnea-orthodeoxia syndrome should be suspected when normal arterial oxygen saturations are recorded while an individual is supine, followed by abrupt declines in those saturations when upright. Further investigations with use of imaging and cardiac catheterization aid in the evaluation. When platypnea-orthodeoxia syndrome is due to intracardiac shunting without pulmonary hypertension, intracardiac shunt closure can be curative. In this article, we report a case of platypnea-orthodeoxia syndrome in an 83-year-old woman who was successfully treated by means of percutaneous transcatheter closure of an atrial septal defect.
ISSN:0730-2347
1526-6702
DOI:10.14503/THIJ-14-4596