Platypnea-Orthyodeoxia Syndrome, a Hidden Cause of Dyspnea?

Anibal A. Arias, Pablo F. Oberti, Mariano L. Falconi, Carlos Rojas Matas, Diego Funes, Arturo M Cagide


A patent foramen ovale (PFO) is an atrial septal defect with or without atrial septal aneurysm, and is associated with left-to-right shunt. It is also associated with embolic stroke and platypnea-orthyodeoxia syndrome. This report describes the case of a patient with platypnea-orthyodeoxia syndrome, which represented a diagnostic challenge because she was admitted due to pneumonia but then was incidentally diagnosed pulmonary thromboembolism (PTE). Given the unfavorable progression of her condition, and her dyspnea with hypoxemia induced by upright position, a transesophageal echocardiography (TEE) was performed, which showed a PFO with atrial septal aneurysm and marked right-to-left bubble passage occurring spontaneously (in dorsal recumbent position). Percutaneous closure of patent foramen ovale with Amplatzer device was performed after a course of antibiotics was given.


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Revista argentina de cardiología. ISSN en línea 1850-3748. Argentine journal of cardiology (English ed. Online ISSN 2314-2286) Sociedad Argentina de Cardiología. Azcuénaga 980 (C1115AAD),Ciudad Autónoma de Buenos Aires, República Argentina. Tel. (54 11) 4961-6027/8/9 Fax: 4961-6020