Positional cyanosis reveals platypnea-orthodeoxia-syndrome
Colin M Kenny1, Caroline E Murphy1, Lindsay Clough1
1Tripler Army Medical Center, Department of Medicine, Division of Internal Medicine, USA.
Abstract:
Platypnea-orthodeoxia syndrome is a rare cause of dyspnea, which presents upon standing and resolves when supine. Etiology is multifactorial with a functional component and an anatomical shunt. The most commonly reported shunt is an atrial septal defect, however a shunt can occur in advanced hepatic or pulmonary disease. Treatment is dependent on the type and location of the shunt. In atrial septal defects percutaneous repair is preferred. To follow is a case of iatrogenic platypnea-orthodeoxia syndrome secondary to heart failure guideline directed medical therapy in a 79 year-old woman.
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