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Abstract

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Article in Japanese

Case Report

Platypnea-orthodeoxia syndrome during long-term observation for unexplained hypoxia: a case report

Kazunori Shimizu  Yoshimi Noda  Kanako Tamura  Takuji Nishida  Hiroshi Morishita  Hiroto Matsuoka 

Osaka Prefectural Hospital Organization, Osaka Habikino Medical Center

ABSTRACT

An 82-year-old woman presented with unexplained hypoxia that had persisted for several years; dyspnea worsened while in an upright posture. We diagnosed platypnea-orthodeoxia syndrome (POS) because her symptom improved while in the lying down position. Cardiac angiography confirmed a right-to-left shunting across a patent foramen ovale (PFO) without an elevated right-left pressure gradient. We speculated that an increase in right-to-left shunting through PFO with blood flow from the inferior vena cava may account for POS under kyphosis due to aging. After a percutaneous transcatheter closure of the PFO performed with the Amplatzer septal occluder, her peripheral oxygen blood saturation levels improved in the upright position. In conclusion, for elderly patients with unexplained hypoxia, we should consider altering the peripheral oxygen blood saturation by changing the patient's position.

KEYWORDS

Platypnea-orthodeoxia syndrome (POS)  Patent foramen ovale (PFO)  Elderly patient  Kyphosis 

Received 3 Dec 2018 / Accepted 10 May 2019

AJRS, 8(4): 293-297, 2019

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