Carrasquel-Alvarez Michelle, Quasem Khaleel, George Varun, Elisevich Lee, Mughal Majid
McLaren Greater Lansing, Lansing, Michigan, USA; Michigan State University, East Lansing, Michigan, USA.
McLaren Greater Lansing, Lansing, Michigan, USA; Michigan State University, East Lansing, Michigan, USA.
JACC Case Rep. 2025 Jul 30;30(21):104433. doi: 10.1016/j.jaccas.2025.104433. Epub 2025 Jun 27.
Platypnea-orthodeoxia syndrome (POS) is a rare condition characterized by dyspnea and hypoxia exacerbated by an upright position. It is often associated with intracardiac or pulmonary shunting.
An 82-year-old woman presented with increasing fatigue, dizziness, and worsening dyspnea on exertion for 1 month. She was hypoxic, requiring high-flow oxygen. Initial work-up, including imaging and right heart catheterization, revealed an aneurysmal interatrial septum with a right-to-left shunt through a patent foramen ovale (PFO). The patient underwent successful percutaneous closure of the PFO, resulting in resolution of hypoxia and dyspnea.
POS should be suspected in cases of positional hypoxia. The pathophysiology involves anatomical and hemodynamic factors that promote right-to-left shunting in specific positions. PFO closure is the definitive treatment, leading to symptom resolution.
TAKE-HOME MESSAGES: POS should be considered in patients with unexplained positional hypoxia. PFO closure can significantly improve symptoms and quality of life in affected patients.
平卧呼吸-直立性低氧血症综合征（POS）是一种罕见病症，其特征为呼吸困难和低氧血症在直立位时加重。它常与心内或肺内分流相关。
一名82岁女性因1个月来疲劳加重、头晕以及劳力性呼吸困难恶化前来就诊。她存在低氧血症，需要高流量吸氧。包括影像学检查和右心导管检查在内的初始检查发现房间隔瘤，伴有通过卵圆孔未闭（PFO）的右向左分流。该患者成功接受了PFO经皮封堵术，低氧血症和呼吸困难得以缓解。
对于体位性低氧血症病例应怀疑POS。其病理生理学涉及在特定体位促进右向左分流的解剖学和血流动力学因素。PFO封堵是确定性治疗方法，可使症状缓解。
对于不明原因体位性低氧血症患者应考虑POS。PFO封堵可显著改善受影响患者的症状和生活质量。
