Lopez Gaston Osvaldo D, Calnevaro Oscar, Gallego Claudio, Bluguermann Jorge, Barbieri David, Granja Miguel, Mc Loughlin Diego, Malvino Eduardo
División Terapia Intensiva, Policlínica Bancaria, Buenos Aires, Argentina.
Medicina (B Aires). 2005;65(3):252-4.
Platypnea-orthodeoxia is an uncommon syndrome of dyspnea and hypoxemia induced by upright position, which is subsequently relieved by recumbency. The case reported involved a 75-year-old man with a seven days history of dyspnea in the upright position. The chest radiograph and CT scan demonstrated an elevated right hemidiaphragm. A surface echocardiogram with saline solution showed a patent foramen ovale (PFO) and atrial septal aneurysm. A pulmonary arteriogram was performed showing no evidence of pulmonary embolism and normal pulmonary arterial pressures. Later, he also developed dyspnea in the supine position and a transesophageal echocardiogram with contrast demonstrated a large right to left shunt through a PFO. The closure by a catheter-deployed double-umbrella device caused an immediate improvement in the patient's oxygenation.
平卧呼吸-直立性低氧血症是一种由直立位诱发的、以呼吸困难和低氧血症为表现的罕见综合征，平卧后症状可缓解。报道的该病例为一名75岁男性，有7天直立位呼吸困难病史。胸部X线片和CT扫描显示右半膈抬高。经盐水负荷的体表超声心动图显示卵圆孔未闭（PFO）和房间隔瘤。肺动脉造影显示无肺栓塞证据且肺动脉压正常。后来，他仰卧位时也出现呼吸困难，经食管对比超声心动图显示通过PFO有大量右向左分流。通过导管置入双伞装置封堵后，患者的氧合情况立即得到改善。
