Publication Date
8-1-2020
Journal
The Texas Heart Journal
DOI
10.14503/THIJ-16-6094
PMID
33472229
PMCID
PMC7819445
PubMedCentral® Posted Date
8-20-2020
PubMedCentral® Full Text Version
Post-print
Published Open-Access
yes
Keywords
Adult, Cardiac Catheterization, Dyspnea, Echocardiography, Transesophageal, Female, Heart Septal Defects, Atrial, Humans, Hypoxia, Syndrome, Defibrillators, implantable/adverse effects; dyspnea/etiology; heart septal defects, atrial/complications/diagnostic imaging/therapy; hypoxia/etiology; posture/physiology; treatment outcome; tricuspid valve insufficiency/complications
Abstract
Platypnea-orthodeoxia syndrome, a rare condition characterized by posture-related dyspnea, is usually caused by an intracardiac shunt, hepatopulmonary syndrome, or shunting resulting from severe pulmonary disease. We report the case of a 33-year-old woman who presented with increasing dyspnea and oxygen desaturation when she sat up or arose. Our diagnosis was platypnea-orthodeoxia syndrome. A lead of a previously implanted pacemaker exacerbated a severe tricuspid regurgitant jet that was directed toward the patient's intra-atrial septum. Percutaneous closure of a small secundum atrial septal defect eliminated right-to-left shunting and substantially improved the patient's functional status. In addition to this case, we discuss this unusual condition.
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