2], with a clinical presentation of platypnea (dyspnea induced by upright posture) and orthodeoxia
(>5% desaturation or >4mmHg Pa[O.
There are some typical conditions when PFO can worsen hypoxemia such as valvular PS, Ebstein anomaly, RV myocardial infarction, orthodeoxia
platypnoea syndrome, chronic obstructive pulmonary diseases, pulmonary hypertension (primary or secondary).
One unique patient in our study presented with platypnea (dyspnea on standing) and orthodeoxia
(hypoxemia on standing) because of pulmonary hypertension from tumor emboli in combination with a patent foramen ovale that created a right-to-left intracardiac shunt and the reduced venous return to the heart on standing left an insufficient amount of unshunted blood to keep him from deoxygenation.
, a drop in oxygen saturation associated with vertical posture, is characteristically present in HPS, but not in porto-pulmonary hypertension, which is much more serious, but thankfully a much less common complication of PHT in childhood.
3) Pulmonary symptoms include dyspnea, fatigue, cyanosis, and orthodeoxia
(decreased arterial oxygen content while upright), all due to right-to-left shunting of blood through the pulmonary AVM.
Platypnea and orthodeoxia are not pathognomonic for HPS.
Exercise-aggravated hypoxemia and orthodeoxia in cirrhosis.
Several days after extubation, hypoxemia with wide A-a gradient (622 mmHg while receiving 100% FiO2 via non-rebreathing mask) and orthodeoxia (SpO2 88% while in the supine position, decreasing to 79% upon assuming and upright posture) were notable.
This syndrome should be suspected in any patient with underlying liver disease presenting with platypnea and orthodeoxia.