Platypnea‐Orthodeoxia Syndrome Post‐Pneumonectomy: A Case of Right‐To‐Left Shunting and Successful PFO Closure
ABSTRACT Platypnea‐orthodeoxia syndrome is a rare disorder characterized by dyspnea (platypnea) and arterial desaturation (orthodeoxia) in the upright position, with symptom relief upon lying down. This syndrome is commonly associated with cardiac anomalies, particularly patent foramen ovale (PFO),...
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Wiley
2025-08-01
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| Series: | Clinical Case Reports |
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| Online Access: | https://doi.org/10.1002/ccr3.70715 |
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| author | Cristian Castillo‐Rodriguez Dina Soliman Michel Juarez Sherif Roman John Abdelmalek Zhaunn Sly Ankush Lahoti Victor Test |
| author_facet | Cristian Castillo‐Rodriguez Dina Soliman Michel Juarez Sherif Roman John Abdelmalek Zhaunn Sly Ankush Lahoti Victor Test |
| author_sort | Cristian Castillo‐Rodriguez |
| collection | DOAJ |
| description | ABSTRACT Platypnea‐orthodeoxia syndrome is a rare disorder characterized by dyspnea (platypnea) and arterial desaturation (orthodeoxia) in the upright position, with symptom relief upon lying down. This syndrome is commonly associated with cardiac anomalies, particularly patent foramen ovale (PFO), where increased right atrial pressure facilitates right‐to‐left shunting, leading to hypoxemia. Other associated conditions include cirrhosis, pericardial effusion, and pneumonectomy. We present a 32‐year‐old female with a history of right pneumonectomy for invasive aspergillosis who presented with worsening dyspnea and a greater than 10% drop in SpO2 when seated compared to the supine position. Initial imaging demonstrated rightward displacement of thoracic structures, including the right atrium, but a transthoracic echocardiogram was negative for intracardiac shunt. Due to persistent hypoxemia, a transesophageal echocardiogram was performed, revealing a right‐to‐left shunt, an atrial septal aneurysm, and a prominent Eustachian valve. The patient underwent successful PFO closure, leading to the complete resolution of both dyspnea and hypoxemia. This case emphasizes the importance of comprehensive diagnostic evaluation in patients with POS, especially those with complex cardiopulmonary histories. |
| format | Article |
| id | doaj-art-dea40053a2e247939bd896d92b2f94c6 |
| institution | Kabale University |
| issn | 2050-0904 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical Case Reports |
| spelling | doaj-art-dea40053a2e247939bd896d92b2f94c62025-08-22T07:33:07ZengWileyClinical Case Reports2050-09042025-08-01138n/an/a10.1002/ccr3.70715Platypnea‐Orthodeoxia Syndrome Post‐Pneumonectomy: A Case of Right‐To‐Left Shunting and Successful PFO ClosureCristian Castillo‐Rodriguez0Dina Soliman1Michel Juarez2Sherif Roman3John Abdelmalek4Zhaunn Sly5Ankush Lahoti6Victor Test7Department of Internal Medicine Texas Tech University Health Sciences Center Lubbock Texas USADepartment of Internal Medicine Texas Tech University Health Sciences Center Lubbock Texas USADepartment of Internal Medicine Texas Tech University Health Sciences Center Lubbock Texas USADivision of Cardiology Texas Tech University Health Sciences Center Lubbock Texas USADivision of Cardiology Texas Tech University Health Sciences Center Lubbock Texas USADivision of Cardiology Texas Tech University Health Sciences Center Lubbock Texas USADivision of Cardiology Texas Tech University Health Sciences Center Lubbock Texas USADivision of Pulmonary and Critical Care Texas Tech University Health Sciences Center Lubbock Texas USAABSTRACT Platypnea‐orthodeoxia syndrome is a rare disorder characterized by dyspnea (platypnea) and arterial desaturation (orthodeoxia) in the upright position, with symptom relief upon lying down. This syndrome is commonly associated with cardiac anomalies, particularly patent foramen ovale (PFO), where increased right atrial pressure facilitates right‐to‐left shunting, leading to hypoxemia. Other associated conditions include cirrhosis, pericardial effusion, and pneumonectomy. We present a 32‐year‐old female with a history of right pneumonectomy for invasive aspergillosis who presented with worsening dyspnea and a greater than 10% drop in SpO2 when seated compared to the supine position. Initial imaging demonstrated rightward displacement of thoracic structures, including the right atrium, but a transthoracic echocardiogram was negative for intracardiac shunt. Due to persistent hypoxemia, a transesophageal echocardiogram was performed, revealing a right‐to‐left shunt, an atrial septal aneurysm, and a prominent Eustachian valve. The patient underwent successful PFO closure, leading to the complete resolution of both dyspnea and hypoxemia. This case emphasizes the importance of comprehensive diagnostic evaluation in patients with POS, especially those with complex cardiopulmonary histories.https://doi.org/10.1002/ccr3.70715atrial septal defectorthodeoxiapatent foramen ovaleplatypnea |
| spellingShingle | Cristian Castillo‐Rodriguez Dina Soliman Michel Juarez Sherif Roman John Abdelmalek Zhaunn Sly Ankush Lahoti Victor Test Platypnea‐Orthodeoxia Syndrome Post‐Pneumonectomy: A Case of Right‐To‐Left Shunting and Successful PFO Closure Clinical Case Reports atrial septal defect orthodeoxia patent foramen ovale platypnea |
| title | Platypnea‐Orthodeoxia Syndrome Post‐Pneumonectomy: A Case of Right‐To‐Left Shunting and Successful PFO Closure |
| title_full | Platypnea‐Orthodeoxia Syndrome Post‐Pneumonectomy: A Case of Right‐To‐Left Shunting and Successful PFO Closure |
| title_fullStr | Platypnea‐Orthodeoxia Syndrome Post‐Pneumonectomy: A Case of Right‐To‐Left Shunting and Successful PFO Closure |
| title_full_unstemmed | Platypnea‐Orthodeoxia Syndrome Post‐Pneumonectomy: A Case of Right‐To‐Left Shunting and Successful PFO Closure |
| title_short | Platypnea‐Orthodeoxia Syndrome Post‐Pneumonectomy: A Case of Right‐To‐Left Shunting and Successful PFO Closure |
| title_sort | platypnea orthodeoxia syndrome post pneumonectomy a case of right to left shunting and successful pfo closure |
| topic | atrial septal defect orthodeoxia patent foramen ovale platypnea |
| url | https://doi.org/10.1002/ccr3.70715 |
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