Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Ann Thorac Surg. 2010 Apr;89(4):1284-6. doi: 10.1016/j.athoracsur.2009.08.050.
Platypnea-orthodeoxia is a rare syndrome presenting with dyspnea and cyanosis induced by an upright position and relieved by recumbency. We report a patient with an excessively enlarged aortic root who had critical hypoxia due to a paradoxical shunt through the patent foramen ovale only when seated. The postural changes of the shunt, caused by changes in posture, were dynamically detected by transesophageal Doppler echocardiography. We believe that this syndrome should be considered when patients with aortic root dilatation present with inexplicable hypoxia, and that transesophageal Doppler echocardiography in the sitting position can be useful for detecting platypnea-orthodeoxia syndrome.
直立位呼吸困难-低氧血症是一种罕见综合征，表现为直立位时呼吸困难和发绀，卧位时缓解。我们报告了一例升主动脉极度扩张的患者，仅在坐位时通过卵圆孔未闭出现反常分流导致严重低氧血症。经食管超声心动图动态检测到分流的体位变化。我们认为，当升主动脉扩张的患者出现不明原因的低氧血症时，应考虑这种综合征，坐位经食管超声心动图有助于检测直立位呼吸困难-低氧血症综合征。
