Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Platypnea-orthodeoxia Syndrome Diagnosed Using Contrast Transesophageal Echocardiography with Simultaneous SpO2 Monitoring
Takayuki SekiharaMasahiro KimuraDaisuke HazamaYuki KimuraHideyuki HayashiMitsumasa OkanoMoritoshi FunasakoKenichi SasakiEisaku NakaneShoichi MiyamotoToshiaki IzumiTetsuya HarunaMotonari FukuiMoriaki Inoko
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JOURNAL OPEN ACCESS

2016 Volume 55 Issue 16 Pages 2203-2207

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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.

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© 2016 by The Japanese Society of Internal Medicine
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