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[Platypnea-orthodeoxia syndrome]
Jan Willem Buikema1, Peter Paul van Geel
1Universitair Medisch Centrum Groningen, afd. Cardiologie, Groningen, the Netherlands.
Nederlands Tijdschrift Voor Geneeskunde
|December 24, 2010
Summary
A rare heart condition, platypnea-orthodeoxia syndrome, caused breathing difficulties in an elderly patient. Diagnosis was confirmed by echocardiography showing a patent foramen ovale, which was successfully treated.
Area of Science:
- Cardiology
- Pulmonology
- Medical Diagnostics
Background:
- Persistent asymptomatic foramen ovale is a common congenital heart defect.
- Platypnea-orthodeoxia syndrome, characterized by dyspnea and hypoxia in the upright position, is an uncommon clinical presentation.
- Elderly patients may present with atypical symptoms of cardiac or pulmonary conditions.
Observation:
- An 82-year-old woman presented with dyspnea and palpitations, initially suspected as atrial fibrillation.
- Positional deoxygenation was noted during examination, prompting further investigation.
- Exclusion of acute cardiac and pulmonary pathologies led to consideration of platypnea-orthodeoxia syndrome.
Findings:
- Transesophageal contrast echocardiography confirmed a patent foramen ovale as the underlying cause.
- The diagnosis of platypnea-orthodeoxia syndrome was established.
- Percutaneous closure of the patent foramen ovale provided curative treatment.
Implications:
- This case highlights the importance of considering platypnea-orthodeoxia syndrome in elderly patients with unexplained positional dyspnea.
- Patent foramen ovale, though often asymptomatic, can manifest later in life with significant cardiopulmonary consequences.
- Timely diagnosis and interventional closure of the foramen ovale can effectively resolve platypnea-orthodeoxia syndrome.
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