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Related Experiment Videos

Postural hypoxemia in the postpneumonectomy patient.

D P Franco, G T Kinasewitz, R V Markham

    The American Review of Respiratory Disease
    |June 1, 1984
    PubMed
    Summary

    Platypnea and orthodeoxia after pneumonectomy were linked to right-to-left intracardiac shunting. This was caused by mechanical distortion of the interatrial septum, increasing blood flow from the inferior vena cava to the left atrium.

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    Area of Science:

    • Cardiology
    • Thoracic Surgery
    • Pulmonary Medicine

    Background:

    • Right pneumonectomy can lead to complex cardiopulmonary complications.
    • Platypnea (dyspnea in upright position) and orthodeoxia (arterial desaturation in upright position) are rare but serious post-pneumonectomy symptoms.

    Observation:

    • A patient presented with platypnea and orthodeoxia following a right pneumonectomy.
    • Cardiac catheterization was performed to investigate the cause of desaturation.

    Findings:

    • The patient exhibited arterial desaturation in the upright position.
    • Increased right-to-left intracardiac shunting through a patent foramen ovale was identified.
    • No pressure gradient between atria suggested mechanical distortion of the interatrial septum as the cause of shunting.

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    Implications:

    • This case highlights a specific mechanism for platypnea-orthodeoxia syndrome post-pneumonectomy.
    • Understanding interatrial septum mechanics is crucial for managing such cases.
    • Suggests potential for interventions targeting septal distortion.