Respiratory distress due to platypnea-orthodeoxia syndrome: A diagnostic challenge in emergency setting

  • Sandro Di Domenico Emergency Department and Urgency Medicine Ward, Niguarda Hospital, Milan, Italy.
  • Paolo Aseni Emergency Department and Urgency Medicine Ward, Niguarda Hospital, Milan, Italy.
  • Luca Bonacchini | luca.bonacchini@ospedaleniguarda.it Emergency Department and Urgency Medicine Ward, Niguarda Hospital, Milan, Italy.
  • Maurizio Bottiroli Anesthesia and Critical Care "De Gasperi" Cardio Center, Niguarda Hospital, Milan, Italy.
  • Rossella Guerrieri Emergency Department and Urgency Medicine Ward, Niguarda Hospital, Milan, Italy.
  • Adriano Basile Emergency Department and Urgency Medicine Ward, Niguarda Hospital, Milan, Italy.
  • Andrea Bellone Emergency Department and Urgency Medicine Ward, Niguarda Hospital, Milan, Italy.

Abstract

Platypnea-orthodeoxia syndrome (POS) is an unusual cause of hypoxia characterized by enormous variation in oxygen saturation during postural changes. We describe here the clinical presentation, the diagnostic challenge of POS and discuss the main pathophysiological etiologies of the disease in a 75-year-old woman who was admitted because shortness of breath. After ruling out the most important causes of dyspnea we observed that the symptoms improved when the patient was lying flat. The diagnostic workup with computed tomography scan and air bubble saline echocardiography lead us to a correct diagnosis.

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Published
2018-06-19
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Issue
Section
Case Reports
Keywords:
Platypnea, Respiratory distress, Patent foramen ovale, Orthodeoxia, Ascending aortic aneurysm.
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How to Cite
Di Domenico, S., Aseni, P., Bonacchini, L., Bottiroli, M., Guerrieri, R., Basile, A., & Bellone, A. (2018). Respiratory distress due to platypnea-orthodeoxia syndrome: A diagnostic challenge in emergency setting. Emergency Care Journal, 14(1). https://doi.org/10.4081/ecj.2018.7265