Annals of The Japanese Respiratory Society:A case of incidentally diagnosed platypnea-orthodeoxia syndrome (POS) that presented with no dyspnea

Vol.12 No.2 Table of Contents

Abstract

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Article in Japanese

Case Report

A case of incidentally diagnosed platypnea-orthodeoxia syndrome (POS) that presented with no dyspnea

Hitomi Hirano^a Kenji Nemoto^b Yoko Eda^a Kengo Nishino^a Takashi Matsuda^a Takefumi Saito^a

^aDepartment of Respiratory Medicine, National Hospital Organization Ibarakihigashi National Hospital
^bNemoto Clinic

ABSTRACT

The patient was a 68-year-old man who was taking oral steroids for organizing pneumonia complicated by pulmonary emphysema. The patient experienced prolonged hypoxemia without dyspnea even after recovery from the pneumonia. A transthoracic echocardiogram and right heart catheterization confirmed an intracardiac shunt from the right to the left atrium. This was diagnosed as platypnea-orthodeoxia syndrome (POS) caused by a patent foramen ovale (PFO). In the present case, it was thought that the preexisting POS was revealed by the increased right-to-left shunting caused by the cardiac morphological changes following the reduction in circulating plasma volume due to pneumonia and steroid use. A worsening ventilation-perfusion imbalance due to pulmonary emphysema and organizing pneumonia may also have contributed to the manifestation of POS.

KEYWORDS

Patent foramen ovale (PFO) Right-left atrial shunt

Received 13 Oct 2022 ／ Accepted 19 Dec 2022

AJRS, 12(2): 102-106, 2023

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