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Platypnoea-Orthodeoxia Syndrome: An Intriguing Diagnosis
Vânia Rodrigues1, Tiago Fernandes Gomes2, Adriana Santos Silva1
1Internal Medicine Department, Centro Hospitalar de Leiria, Leiria, Portugal.
European Journal of Case Reports in Internal Medicine
|April 2, 2019
Summary
Platypnoea-orthodeoxia syndrome (POS) causes shortness of breath when upright, often due to a patent foramen ovale (PFO). Percutaneous PFO closure effectively treated this rare condition in an elderly patient.
Area of Science:
- Cardiology
- Pulmonology
- Medical Case Reports
Background:
- Platypnoea-orthodeoxia syndrome (POS) is a rare condition causing dyspnoea and hypoxaemia in an upright position.
- It is frequently linked to right-to-left shunting through cardiac defects like a patent foramen ovale (PFO) or atrial septal defect.
Purpose of the Study:
- To report a case of POS in an elderly woman with persistent hypoxaemia.
- To highlight the diagnostic pathway and successful treatment of POS via percutaneous PFO closure.
Main Methods:
- Diagnostic workup included CT angiogram, V/Q scan, and transoesophageal echocardiogram with bubble study.
- Treatment involved percutaneous closure of the identified PFO.
Main Results:
- A 79-year-old female presented with positional hypoxaemia unresponsive to infection treatment.
- Transoesophageal echocardiogram revealed a PFO with right-to-left shunting.
- Percutaneous PFO closure resulted in immediate symptom relief and functional recovery.
Conclusions:
- POS should be suspected in cases of unexplained positional hypoxaemia.
- Tilt-table transoesophageal echocardiography is a reliable diagnostic tool for POS.
- Percutaneous PFO closure is a safe and effective treatment option, even for elderly patients.
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