Document Detail

A rare cause of dyspnea and arterial hypoxemia.
MedLine Citation:
PMID:  9404771     Owner:  NLM     Status:  MEDLINE    
Platypnea-orthodeoxia is a rare pattern of dyspnea with arterial hypoxemia. Platypnea is defined as dyspnea induced by upright posture, and it is relieved by the recumbent position. Orthodeoxia refers to arterial desaturation resulting from assuming an erect or upright position. The case reported involves a 59-year-old man with profound, unexplained dyspnea despite extensive investigation performed at the referring institution. The difficulty in diagnosis persisted until it was recognized that the investigations, in having been performed under "standard" (supine) conditions, were insufficient and therefore misleading. Despite normal supine intracardiac pressures, a patent foramen ovale was shown to give rise to a large orthostatic intracardiac shunt, demonstrated by means of an echocardiogram performed with the patient supine and upright. Surgical closure of the foramen was followed by dramatic clinical improvement. Among dyspneic patients, discernment of a pattern of platypnea and orthodeoxia is key to effective evaluation.
T Al Khouzaie; J R Busser
Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Chest     Volume:  112     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  1997 Dec 
Date Detail:
Created Date:  1998-01-06     Completed Date:  1998-01-06     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1681-2     Citation Subset:  AIM; IM    
Department of Medicine, University of British Columbia and Vancouver Hospital and Health Sciences Centre, Canada.
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MeSH Terms
Anoxia / diagnosis,  etiology*
Chronic Disease
Diagnosis, Differential
Dyspnea / diagnosis,  etiology*
Heart Septal Defects, Atrial / complications,  diagnosis
Middle Aged
Comment In:
Chest. 1997 Dec;112(6):1449-51   [PMID:  9404736 ]

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