Document Detail

Transient platypnea-orthodeoxia-like syndrome induced by propafenone overdose in a young woman with Ebstein's anomaly.
MedLine Citation:
PMID:  14976857     Owner:  NLM     Status:  MEDLINE    
In this report we describe the case of a 37-year-old white woman with Ebstein's anomaly, who developed a rare syndrome called platypnea-orthodeoxia, characterized by massive right-to-left interatrial shunting with transient profound hypoxia and cyanosis. This shunt of blood via a patent foramen ovale occurred in the presence of a normal pulmonary artery pressure, and was probably precipitated by a propafenone overdose. This drug caused biventricular dysfunction, due to its negative inotropic effect, and hypotension, due to its peripheral vasodilatory effect. These effects gave rise to an increase in the right atrial pressure and a decrease in the left one with a consequent stretching of the foramen ovale and the creation of massive right-to-left shunting. In our case this interatrial shunt was very accurately detected at bubble contrast echocardiography.
Daisy Pavoni; Sonia Ragazzo; Mauro Driussi; Francesco Antonini-Canterin; Daniela Pavan; Fabio Zardo; Gian Luigi Nicolosi
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Italian heart journal : official journal of the Italian Federation of Cardiology     Volume:  4     ISSN:  1129-471X     ISO Abbreviation:  Ital Heart J     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2004-02-23     Completed Date:  2004-04-23     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  100909716     Medline TA:  Ital Heart J     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  891-4     Citation Subset:  IM    
Division of Cardiology, S. Maria degli Angeli Hospital, Pordenone, Italy.
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MeSH Terms
Anoxia / chemically induced*,  diagnosis
Anti-Arrhythmia Agents / administration & dosage*,  adverse effects*
Cyanosis / chemically induced*,  diagnosis
Dose-Response Relationship, Drug
Ebstein Anomaly / drug therapy*
Heart Atria / drug effects,  pathology,  ultrasonography
Heart Septal Defects, Atrial / chemically induced,  diagnosis
Heart Ventricles / drug effects,  pathology,  ultrasonography
Propafenone / administration & dosage*,  adverse effects*
Tachycardia, Supraventricular / drug therapy
Ventricular Dysfunction / chemically induced,  diagnosis
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 54063-53-5/Propafenone

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