Platypnea-orthodeoxia Syndrome Diagnosed Using Contrast Transesophageal Echocardiography with Simultaneous SpO2 Monitoring

Platypnea-orthodeoxia syndrome (POS) is a rare condition characterized by interatrial right-to-left shunting that is exacerbated in the upright position. We herein report a 78-year-old woman with POS that remained undiagnosed for 2 years, despite repetitive transthoracic echocardiography (TTE). POS...

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Published inInternal Medicine Vol. 55; no. 16; pp. 2203 - 2207
Main Authors Sekihara, Takayuki, Kimura, Masahiro, Hazama, Daisuke, Kimura, Yuki, Hayashi, Hideyuki, Okano, Mitsumasa, Funasako, Moritoshi, Sasaki, Kenichi, Nakane, Eisaku, Miyamoto, Shoichi, Izumi, Toshiaki, Haruna, Tetsuya, Fukui, Motonari, Inoko, Moriaki
Format Journal Article
LanguageEnglish
Published Japan The Japanese Society of Internal Medicine 2016
Subjects
Aged
contrast echocardiography
Dyspnea - diagnosis
Echocardiography, Transesophageal
Female
Heart Diseases - diagnosis
Heart Diseases - diagnostic imaging
Humans
Oxygen - blood
platypnea-orthodeoxia syndrome
Posture
Syndrome
transesophageal echocardiography
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Abstract Platypnea-orthodeoxia syndrome (POS) is a rare condition characterized by interatrial right-to-left shunting that is exacerbated in the upright position. We herein report a 78-year-old woman with POS that remained undiagnosed for 2 years, despite repetitive transthoracic echocardiography (TTE). POS was ultimately diagnosed using contrast transesophageal echocardiography (TEE), which revealed a marked increase in right-to-left shunting in the sitting position, associated with simultaneous desaturation. Therefore, we propose that POS should be considered according to the clinical symptoms, regardless of the repetitive TTE results, and contrast TEE should be performed in both the supine and sitting positions to exclude a diagnosis of POS.
AbstractList Platypnea-orthodeoxia syndrome (POS) is a rare condition characterized by interatrial right-to-left shunting that is exacerbated in the upright position. We herein report a 78-year-old woman with POS that remained undiagnosed for 2 years, despite repetitive transthoracic echocardiography (TTE). POS was ultimately diagnosed using contrast transesophageal echocardiography (TEE), which revealed a marked increase in right-to-left shunting in the sitting position, associated with simultaneous desaturation. Therefore, we propose that POS should be considered according to the clinical symptoms, regardless of the repetitive TTE results, and contrast TEE should be performed in both the supine and sitting positions to exclude a diagnosis of POS.
Author Sasaki, Kenichi
Miyamoto, Shoichi
Hazama, Daisuke
Kimura, Yuki
Haruna, Tetsuya
Inoko, Moriaki
Funasako, Moritoshi
Fukui, Motonari
Kimura, Masahiro
Sekihara, Takayuki
Okano, Mitsumasa
Nakane, Eisaku
Hayashi, Hideyuki
Izumi, Toshiaki
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Cites_doi 10.1002/clc.22301
10.1002/ccd.25953
10.1161/hc3101.093603
10.1016/j.jcmg.2012.01.015
10.2169/internalmedicine.53.0797
10.1002/clc.20461
10.1016/j.athoracsur.2006.11.004
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SubjectTerms Aged
contrast echocardiography
Dyspnea - diagnosis
Echocardiography, Transesophageal
Female
Heart Diseases - diagnosis
Heart Diseases - diagnostic imaging
Humans
Oxygen - blood
platypnea-orthodeoxia syndrome
Posture
Syndrome
transesophageal echocardiography
Title Platypnea-orthodeoxia Syndrome Diagnosed Using Contrast Transesophageal Echocardiography with Simultaneous SpO2 Monitoring
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