Patent foramen ovale revealed by COVID-19 pneumonia

• Published in: BMC pulmonary medicine Vol. 21; no. 1; pp. 126 - 4
• Main Authors: Vanhomwegen, Charlotte, Taton, Olivier, Selvais, Nicolas, Vanhove, Olivier, Leduc, Dimitri
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 19.04.2021; BioMed Central; BMC
• Subjects: Antibiotics; Bacterial pneumonia; Case Report; Case reports; Case studies; Complications and side effects; Coronaviruses; COVID-19; COVID-19 - diagnosis; COVID-19 - physiopathology; Diagnosis; Dyspnea; Dyspnea - diagnosis; Dyspnea - etiology; Dyspnea - physiopathology; Echocardiography - methods; Electrocardiography; Foramen Ovale, Patent - complications; Foramen Ovale, Patent - diagnosis; Foramen Ovale, Patent - physiopathology; Hemodynamics; Hospitals; Humans; Hypoxemia; Hypoxia; Hypoxia - diagnosis; Hypoxia - etiology; Hypoxia - physiopathology; Intensive care; Lavage; Lung - diagnostic imaging; Lung Diseases, Interstitial - complications; Lung Diseases, Interstitial - physiopathology; Lung Diseases, Interstitial - virology; Lungs; Male; Mechanical ventilation; Middle Aged; Oxygen - analysis; Oxygen saturation; Oxygen therapy; Patent foramen ovale; Patients; Perfusion; Pneumonia; Pneumonia, Viral - complications; Pneumonia, Viral - diagnosis; Pneumonia, Viral - physiopathology; Polymerase chain reaction; Posture - physiology; Pulmonary hypertension; Pulmonary vasoconstriction; Pulmonology; Respiration; Respiratory distress syndrome; Risk factors; SARS-CoV-2; SARS-CoV-2 - isolation & purification; Severe acute respiratory syndrome coronavirus 2; Shortness of breath; Syndrome; Treatment Outcome; Ventilation inhomogeneity; Belgium; Pulmonary vasoconstriction; Patent foramen ovale; SARS-CoV-2; Ventilation inhomogeneity; Hypoxemia
• ISSN: 1471-2466; 1471-2466
• DOI: 10.1186/s12890-021-01494-7

Platypnea-orthodeoxia syndrome (POS) is a rare condition characterized by dyspnoea (platypnea) and arterial desaturation in the upright position resolved in the supine position (orthodeoxia). Intracardiac shunt, pulmonary ventilation-perfusion mismatch and others intrapulmonary abnormalities are involved. We report a case of POS associated with two pathophysiological issues: one, cardiac POS caused by a patent foramen ovale (PFO) and second, pulmonary POS due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) interstitial pneumonia. POS has resolved after recovery of coronavirus disease 2019 (COVID-19) pneumonia. Right-to-left interatrial shunt and intrapulmonary shunt caused by SARS-CoV-2 pneumonia contributed to refractory hypoxemia and POS. Therefore, in case of COVID-19 patient with unexplained POS, the existence of PFO must be investigated.