A Case of Platypnea Orthodeoxia Syndrome: A Persistent History Taking was the Key to the Diagnosis

Takashi Ohfuji; Yasushi Obase; Masaki Ikeda; Kikuko Obase; Akihiro Hayashida; Hiroyuki Okura; Yoshihiro Kobashi; Kiyoshi Yoshida; Mikio Oka

doi:10.2169/internalmedicine.51.7439

CASE REPORTS

A Case of Platypnea Orthodeoxia Syndrome: A Persistent History Taking was the Key to the Diagnosis

Takashi Ohfuji, Yasushi Obase, Masaki Ikeda, Kikuko Obase, Akihiro Hayashida, Hiroyuki Okura, Yoshihiro Kobashi, Kiyoshi Yoshida, Mikio Oka

Author information

Takashi Ohfuji
Department of Respiratory Medicine, Kawasaki Medical School, Japan
Yasushi Obase
Department of Respiratory Medicine, Kawasaki Medical School, Japan
Masaki Ikeda
Department of Respiratory Medicine, Kawasaki Medical School, Japan
Kikuko Obase
Department of Cardiology, Kawasaki Medical School, Japan
Akihiro Hayashida
Department of Cardiology, Kawasaki Medical School, Japan
Hiroyuki Okura
Department of Cardiology, Kawasaki Medical School, Japan
Yoshihiro Kobashi
Department of Respiratory Medicine, Kawasaki Medical School, Japan
Kiyoshi Yoshida
Department of Cardiology, Kawasaki Medical School, Japan
Mikio Oka
Department of Respiratory Medicine, Kawasaki Medical School, Japan

Keywords: hypoxemia, platypnea-orthodeoxia syndrome, atrial septal defect

JOURNAL OPEN ACCESS

2012 Volume 51 Issue 13 Pages 1701-1704

DOI https://doi.org/10.2169/internalmedicine.51.7439

Details

Abstract

A 79-year-old woman who had been suffering from dyspnea on effort for more than 50 years was admitted for further examination and treatment. On the screening respiratory examinations, the A-aDO₂ was elevated but none of diffusion disturbance, ventilation-perfusion ratio inequality nor right-to-left shunt was detected. Finally, the fact that the dizziness occurred only in sitting or standing position was revealed by persistent history taking. Transesophageal echocardiography in recumbent and sitting positions revealed the platypnea orthodeoxia syndrome associated with atrial septal defect. This case highlights the necessity of awareness of this syndrome and the occult atrial septal defect.

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