Platypnea-orthodeoxia syndrome

Platypnea–orthodeoxia syndrome is a condition in which a person has shortness of breath and low oxygen saturations when upright (platypnea and orthodeoxia), but no symptoms when lying down. It can be caused by ventilation-perfusion mismatch, intracardiac shunting, or pulmonary shunting. In some cases, the cause is multifactorial.[1][2]

Platypnea-orthodeoxia syndrome
SpecialtyCardiology, cardiothoracic surgery (primarily),
pulmonology (secondarily),
neurology, hepatology and general surgery
Differential diagnosisIntracardiac shunting

Although the mechanism is still unclear, it is thought to be caused by right to left shunting of blood flow due to an anatomic defect allowing communication between right and left-sided circulation, such as an atrial septal defect, patent foramen ovale, or pulmonary atrioventricular malformations, and a functional component that causes blood to move through the shunt, such as Ebstein's Anomaly, pulmonary hypertension, or absent superior vena cava.[3]

References
  1. Henkin, Stanislav; Negrotto, Sara; Pollak, Peter M.; Cullen, Michael W.; O'Cochlain, D. Fearghas; Wright, R. Scott (2015-10-01). "Platypnea-Orthodeoxia Syndrome: Diagnostic Challenge and the Importance of Heightened Clinical Suspicion". Texas Heart Institute Journal. 42 (5): 498–501. doi:10.14503/THIJ-14-4596. ISSN 0730-2347. PMC 4591898. PMID 26504452.
  2. De Vecchis, Renato; Baldi, Cesare; Ariano, Carmelina (2016-09-23). "Platypnea–Orthodeoxia Syndrome: Multiple Pathophysiological Interpretations of a Clinical Picture Primarily Consisting of Orthostatic Dyspnea". Journal of Clinical Medicine. 5 (10): 85. doi:10.3390/jcm5100085. ISSN 2077-0383. PMC 5086587. PMID 27669319.
  3. Knapper, Joseph T.; Schultz, Jason; Das, Gladwin; Sperling, Laurence S. (October 2014). "Cardiac Platypnea-Orthodeoxia Syndrome: An Often Unrecognized Malady: Cardiac Platypnea-Orthodeoxia Syndrome". Clinical Cardiology. 37 (10): 645–649. doi:10.1002/clc.22301. PMC 6649356. PMID 24912004.


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