Chest
Patent Foramen Ovale Associated with Platypnea and Orthodeoxia
Section snippets
CASE REPORT
A 70-year-old white woman had been in good health until one year prior to presentation when she noted fatigue during physical activity. This had now become progressive; very slight physical effort was associated with severe breathlessness requiring her to sit or lie down to regain her breath. During an airplane flight, acute breathlessness occurred. Since the patient already knew that lying flat caused her acute symptoms to resolve, her condition improved while lying horizontal in an ambulance
DISCUSSION
This report documents a 70-year-old woman who had platypnea and orthodeoxia caused by right-to-left shunting across a patent foramen ovale, even though pulmonary artery pressures and right heart function were normal. In the absence of lung disease, platypnea and orthodeoxia are very unusual occurrences, since it is the associated lung disease that enhances a tendency for right-to-left shunting across a patent foramen ovale.4
The true incidence of patency of the foramen ovale is unknown. Autopsy
REFERENCES (10)
- et al.
Incidence and size of patent foramen ovale during the first 10 decades of life: an autopsy study of 965 normal hearts.
Mayo Clin Proc
(1984) - et al.
Patent foramen ovale in young stroke patients.
Lancet
(1988) - et al.
Platypnea-Orthodeoxia: clinical profile, diagnostic workup, management, and report of seven cases.
Mayo Clin Proc
(1984) - et al.
Functional drainage of the inferior vena cava into the left atrium—three cases.
Am J Cardiol
(1963) - et al.
Cyanosis in uncomplicated atrial septal defect with normal right cardiac and pulmonary arterial pressures.
Chest
(1978)