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

Sandro Di Domenico, Paolo Aseni, Luca Bonacchini, Maurizio Bottiroli, Rossella Guerrieri, Adriano Basile, Andrea Bellone
  • 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
  • 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.

Keywords

Platypnea; Respiratory distress; Patent foramen ovale; Orthodeoxia; Ascending aortic aneurysm.

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Submitted: 2017-12-28 14:28:11
Published: 2018-06-19 09:20:19
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Copyright (c) 2018 Sandro Di Domenico, Paolo Aseni, Luca Bonacchini, Maurizio Bottiroli, Rossella Guerrieri, Adriano Basile, Andrea Bellone

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