The paradox of platypnoea-orthodeoxia syndrome.

Autor: Leaver BA; Department of Respiratory Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia.; Department of Cardiology, Royal Melbourne Hospital, Melbourne, Victoria, Australia., Cliff ERS; Department of Respiratory Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia., Jefford M; Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia., Fogarty S; Department of Cardiology, Royal Melbourne Hospital, Melbourne, Victoria, Australia., Zentner D; Department of Cardiology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.; Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
Jazyk: angličtina
Zdroj: Internal medicine journal [Intern Med J] 2024 Apr; Vol. 54 (4), pp. 675-677. Date of Electronic Publication: 2024 Apr 04.
DOI: 10.1111/imj.16365
Abstrakt: Platypnoea-orthodeoxia is a rare clinical syndrome characterised by dyspnoea and oxygen desaturation in the upright position which improves when supine. It requires two components: a sufficiently sized anatomical vascular defect (typically intra-cardiac or intra-pulmonary) combined with a functional component that promotes positional right-to-left shunting. We describe the rare occurrence of a patient with platypnoea-orthodeoxia syndrome (POS) because of a paradoxical shunt through a patent foramen ovale caused by a large right atrial line-associated thrombus in a male with metastatic oesophageal cancer undergoing chemotherapy. This case is a timely reminder to consider POS amongst differentials for hypoxia as it is often treatable if recognised.
(© 2024 Royal Australasian College of Physicians.)
Databáze: MEDLINE
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