A case of platypnea-orthodeoxia syndrome resulting from atrial septal defect
Takashi Ishiguroa Noboru Takayanagia Manabu Yamamotoa Joshi Tsutsumib Takashi Miyamotob Mina Gochia Yutaka Sugitaa
aDepartment of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center
bDepartment of Cardiology, Saitama Cardiovascular and Respiratory Center
A 76-year-old man who had been diagnosed as having chronic bird-related hypersensitivity pneumonia had received prednisolone. His respiratory condition had been stable; however; O2 saturation measured by pulse oximeter (SpO2) was reduced to 91% (O2 1 L/min, nasal canula), but no cause could be detected on echocardiography or chest computed tomography imaging. In February 2013, he presented as an outpatient with a SpO2 of 73% (O2 4 L/min, nasal canula, sitting position). We discovered that his respiratory condition improved in a supine position, but it worsened in a sitting position, and we diagnosed him as having platypnea-orthodeoxia syndrome. Transesophageal echocardiography showed right-to-left shunting of blood flow through an atrial septal defect. In the present case, reduced lung volume resulting from chronic hypersensitivity pneumonia possibly contributing to development of the platypnea-orthodeoxia syndrome.
Platypnea Orthodeoxia Atial septal defect Shunt Chronic hypersensitivity pneumonia
Received 2 Sep 2013 / Accepted 13 Nov 2013
AJRS, 3(2): 287-292, 2014