Postural nausea due to platypnea orthodeoxia

Platypnea orthodeoxia is an uncommon condition but given its associations with severe lung disease and advancing age, it might be seen in the palliative care population. Presentation is classical in the association of symptoms with postural change. It should be considered when patients present with breathlessness or desaturation given the minimally invasive tests of echocardiography, and the potential for procedural resolution of the defect and thus symptoms. Further, there has not previously been reported a case presenting with nausea (rather than dyspnoea) secondary to platypnea orthodeoxia syndrome. This unusual presentation is a reminder that there is a broad range of potential subjective experiences of the same physiological events. Careful history and examination are vital in elucidating the underlying cause.