COVID-19 肺炎引发的卵圆孔未闭。
Patent foramen ovale revealed by COVID-19 pneumonia.
机构信息
CHU Erasme Hospital, Université Libre de Bruxelles, Route de Lennick 808, 1070, Brussels, Belgium.
Department of Pneumology, CHU Erasme Hospital, Université Libre de Bruxelles, Bruxelles, Belgium.
出版信息
BMC Pulm Med. 2021 Apr 19;21(1):126. doi: 10.1186/s12890-021-01494-7.
BACKGROUND
Platypnea-orthodeoxia syndrome (POS) is a rare condition characterized by dyspnoea (platypnea) and arterial desaturation in the upright position resolved in the supine position (orthodeoxia). Intracardiac shunt, pulmonary ventilation-perfusion mismatch and others intrapulmonary abnormalities are involved.
CASE PRESENTATION
We report a case of POS associated with two pathophysiological issues: one, cardiac POS caused by a patent foramen ovale (PFO) and second, pulmonary POS due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) interstitial pneumonia. POS has resolved after recovery of coronavirus disease 2019 (COVID-19) pneumonia.
CONCLUSIONS
Right-to-left interatrial shunt and intrapulmonary shunt caused by SARS-CoV-2 pneumonia contributed to refractory hypoxemia and POS. Therefore, in case of COVID-19 patient with unexplained POS, the existence of PFO must be investigated.
背景
直立性呼吸困难-低氧血症综合征（POS）是一种罕见病症，其特征是直立时呼吸困难（呼吸困难）和动脉血氧饱和度降低，而仰卧时（低氧血症）得到缓解。涉及心内分流、肺通气-灌注不匹配和其他肺内异常。
病例介绍
我们报告了一例与两个病理生理问题相关的 POS 病例：一是由卵圆孔未闭（PFO）引起的心脏 POS，二是由严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）间质性肺炎引起的肺 POS。COVID-19 肺炎痊愈后，POS 得到缓解。
结论
由 SARS-CoV-2 肺炎引起的右向左房间分流和肺内分流导致难治性低氧血症和 POS。因此，对于 COVID-19 患者出现不明原因的 POS，必须调查 PFO 的存在。
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