Platypnea-Orthodeoxia Syndrome: A Case of Chronic Paroxysmal Hypoxemia.

Autor: Rudy CC; School of Medicine, Oregon Health & Science University, Portland, OR, USA.; Oregon Health & Science University, 3181 SW Sam Jackson Park Road Mail Code: BTE119, Portland, OR, 97239, USA., Ballard C; The Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA.; Oregon Health & Science University, 3181 SW Sam Jackson Park Road Mail Code: BTE119, Portland, OR, 97239, USA., Broberg C; The Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA.; Oregon Health & Science University, 3181 SW Sam Jackson Park Road Mail Code: BTE119, Portland, OR, 97239, USA., Hunter AJ; Division of Hospital Medicine, Department of Medicine, Oregon Health & Science University, Portland, OR, USA. huntera@ohsu.edu.; Oregon Health & Science University, 3181 SW Sam Jackson Park Road Mail Code: BTE119, Portland, OR, 97239, USA. huntera@ohsu.edu.
Jazyk: angličtina
Zdroj: Journal of general internal medicine [J Gen Intern Med] 2017 Jan; Vol. 32 (1), pp. 127-130. Date of Electronic Publication: 2016 Oct 26.
DOI: 10.1007/s11606-016-3901-1
Abstrakt: A 75-year-old man with chronic (30-year) unexplained paroxysmal hypoxemia presented with postural hypoxemia and desaturation consistent with a clinical manifestation of platypnea-orthodeoxia syndrome. His history included a lack of significant past pulmonary disease, yet with intermittent need for oxygen supplementation. On admission he was found to have an interatrial shunt through a patent foramen ovale. Device closure by percutaneous catheterization led to sustained resolution of symptoms. Platypnea-orthodeoxia syndrome is a rare but important consideration in the differential diagnosis of hypoxemia, as it represents a potentially curable cause of hypoxemia, with missed diagnosis leading to possible patient morbidity if untreated. Even more importantly, an astute and careful history and physical examination are integral to the diagnosis of this rare but likely under-recognized syndrome.
Competing Interests: Dr. Craig Broberg has been awarded a National Heart, Lung, and Blood Institute (NHLBI) grant to investigate bicuspid valve aortopathy. All remaining authors declare that they do not have a conflict of interest.
Databáze: MEDLINE
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