Posture-Related Change in Intracardiac Blood Flow Detected by Transesophageal Echocardiography in Platypnea-Orthodeoxia Syndrome

Mima, Hiroyuki; Sakamoto, Jiro; Miyake, Makoto; Tamaki, Yodo; Enomoto, Soichiro; Kondo, Hirokazu; Tamura, Toshihiro

doi:10.1016/j.case.2022.03.007

Cited by 4 publications

(4 citation statements)

References 8 publications

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“…Additionally, the aortic arch may positionally compress the SVC [ 1 , 3 , 10 ]. These anatomical irregularities are particularly prominent in the right lateral decubitus position and while sitting, which helps sustain interatrial communication [ 19 - 20 ].…”

Section: Discussionmentioning

confidence: 99%

Cardiac Platypnea-Orthodeoxia Syndrome: A Rare Case of Flow-Directed, Right-to-Left Shunt via a Patent Foramen Ovale Exacerbated by Aortic Root Enlargement

Molina-Lopez,

Diaz-Rodriguez,

Aviles-Rivera

et al. 2023

Cureus

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Cardiac platypnea-orthodeoxia is a unique clinical syndrome characterized by dyspnea and deoxygenation when moving from a supine to an upright position. In this case report, we detail the experience of a 78-year-old male with persistent hypoxemia following a paradoxical embolic ischemic stroke. Despite proper management of his respiratory symptoms, the patient continued to be affected by marked dyspnea and hypoxemia, particularly when upright or in a right-sided decubitus position. Subsequent investigation revealed that his hypoxemia was a result of cardiac platypnea-orthodeoxia syndrome (POS). This condition was attributed to the enlargement of his aortic root and ascending aorta, coupled with a counterclockwise rotation of the heart axis. These factors facilitated a flow-directed, right-to-left interatrial shunt through a patent foramen ovale, even in the absence of elevated right heart pressures.

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Section: Discussionmentioning

confidence: 99%

Cardiac Platypnea-Orthodeoxia Syndrome: A Rare Case of Flow-Directed, Right-to-Left Shunt via a Patent Foramen Ovale Exacerbated by Aortic Root Enlargement

Molina-Lopez,

Diaz-Rodriguez,

Aviles-Rivera

et al. 2023

Cureus

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“…Right-to-left shunting via an intracardiac communication such as a PFO or atrial septal defect (ASD) is the most common cause. Although previous reports have hypothesised why right-to-left shunting is exacerbated in the upright position, the underlying mechanisms are not fully understood [2].…”

Section: Introductionmentioning

confidence: 97%

Platypnea-Orthodeoxia Syndrome in an Elderly Patient Treated with Percutaneous Patent Foramen Ovale Closure: Report of a Case and Review of the Literature

Diouldé,

Mariama,

Madiou

et al. 2023

WJCD

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Introduction: Platypnea-Orthodeoxia syndrome is characterized by dyspnea and hypoxia in the upright position, usually improving in the supine position. Two components are required: an interatrial or intrapulmonary shunt, and a functional component. Diagnosis is made by contrast ultrasonography. We report a case of Platypnea-Orthodeoxia syndrome revealed by positional dyspnea in an 87-year-old patient. The aim of this study is to describe the clinical, therapeutic and evolutionary profile of this syndrome. Case Presentation: This is an 87-year-old patient with a history of pulmonary embolism (PE) and stroke. He was seen for dyspnea and desaturation in orthostatism, revealing a patent foramen ovale (PFO). Progression was favorable after closure of the PFO. Conclusion: Platypnea-Orthodeoxia syndrome may be presented as simple exertional dyspnea. The clinician should check for improvement in symptoms and/or oxygenation during decubitus. Definitive treatment consists of percutaneous closure of the shunt.

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“…The most common cause is a patent foramen ovale (PFO) or atrial septal defect with right-to-left shunting in the upright position. Most patients with an intracardiac shunt causing POS demonstrate a secondary anatomic or a functional defect that redirects preferential flow causing right-to-left shunting in the upright position [ [2] , [3] , [4] ] . Other causes are rare and underlying pathophysiologic mechanisms are not completely understood.…”

Section: Introductionmentioning

confidence: 99%

Position dependent dyspnea and hypoxemia

Hoppe,

van Dam,

Dik

2023

Respiratory Medicine Case Reports

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Posture-Related Change in Intracardiac Blood Flow Detected by Transesophageal Echocardiography in Platypnea-Orthodeoxia Syndrome

Cited by 4 publications

References 8 publications

Cardiac Platypnea-Orthodeoxia Syndrome: A Rare Case of Flow-Directed, Right-to-Left Shunt via a Patent Foramen Ovale Exacerbated by Aortic Root Enlargement

Cardiac Platypnea-Orthodeoxia Syndrome: A Rare Case of Flow-Directed, Right-to-Left Shunt via a Patent Foramen Ovale Exacerbated by Aortic Root Enlargement

Platypnea-Orthodeoxia Syndrome in an Elderly Patient Treated with Percutaneous Patent Foramen Ovale Closure: Report of a Case and Review of the Literature

Position dependent dyspnea and hypoxemia

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