Abstract

LOPEZ GASTON, Osvaldo D. et al. Platypnea-orthodeoxia syndrome, atrial septal aneurysm and right hemidiaphragmatic elevation with a right-to-left shunt through a patent foramen ovale. Medicina (B. Aires) [online]. 2005, vol.65, n.3, pp.252-254. ISSN 0025-7680.

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 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.

Keywords : Platypnea-orthodeoxia syndrome; Patent foramen ovale; Hypoxemia; Right-to-left shunt; Atrial septal  aneurysm; Diaphragmatic palsy.

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