دورية أكاديمية

Platypnea-orthodeoxia due to osteoporosis and severe kyphosis: a rare cause for dyspnea and hypoxemia

التفاصيل البيبلوغرافية
العنوان: Platypnea-orthodeoxia due to osteoporosis and severe kyphosis: a rare cause for dyspnea and hypoxemia
المؤلفون: Teupe, Claudius HJ, Groenefeld, Gerian C
المصدر: Heart International, vol 6, iss 2
بيانات النشر: eScholarship, University of California
سنة النشر: 2011
المجموعة: University of California: eScholarship
مصطلحات موضوعية: Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Clinical Sciences, Lung, Cardiovascular, Heart Disease, Aetiology, 2.1 Biological and endogenous factors, kyphosis, orthodeoxia, patent foramen ovale, platypnea, transcatheter closure
جغرافية الموضوع: 13 - 13
الوصف: Platypnea orthodeoxia is a rare disorder characterized by dyspnea and arterial desaturation, exacerbated by the upright position and relieved when the subject is recumbent. We report the case of a 79-year old woman admitted to hospital with dyspnea who was thought to have restrictive ventilatory impairment due to osteoporosis and severe kyphosis. Interestingly, the dyspnea was aggravated in the upright position, whereas the symptoms improved in the supine position. Arterial blood gas analysis confirmed orthodeoxia. The lung function test showed only a mild obstructive and restrictive ventilation disorder. Echocardiography revealed a patent foramen ovale and an aneurysm of the atrial septum protruding into the left atrium, despite normal right atrial pressure. Transesophageal echocardiography showed a prominent Eustachian valve guiding a blood flow from the inferior vena cava directly onto the atrial septum, thereby pushing open the patent foramen ovale. Contrast-enhanced echocardiography confirmed a spontaneous right-to-left shunt through the patent foramen ovale. It was assumed that the platypnea-orthodeoxia was caused by a prominent Eustachian valve redirected to the patent foramen ovale as a result of severe osteoporosis with subsequent thoracic kyphosis and a change in the position of the entire heart. The patient underwent permanent transcatheter closure of the patent foramen ovale after hemodynamic assessment had confirmed a significant right-to-left shunt through it. After the procedure the arterial oxygen pressure increased significantly in the upright position and dyspnea improved.
نوع الوثيقة: article in journal/newspaper
وصف الملف: application/pdf
اللغة: unknown
العلاقة: qt99s2c3x5; https://escholarship.org/uc/item/99s2c3x5Test
الإتاحة: https://escholarship.org/uc/item/99s2c3x5Test
حقوق: public
رقم الانضمام: edsbas.6D336E44
قاعدة البيانات: BASE