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Summary
Platypnoea Orthodeoxia syndrome is defined by dyspnoea and hypoxaemia exacerbated by orthostatic positioning and alleviated in recumbency. This condition has been reported in association with pulmonary, hepatic and cardiac disease. We describe a case herein of a 79 year old female who developed severe hypoxaemia and dyspnoea post laparoscopic cholecystectomy. A difference in arterial blood gas oxygen tension was demonstrated in the supine and erect positions on arterial blood gas analysis. A Patent Foramen Ovale (PFO) with a right to left shunt was evident on echocardiogram employing colour doppler and agitated normal saline studies. Definitive management, with closure of the patent foramen ovale lead to a complete resolution of symptoms and normalisation of arterial blood gas parameters in both the supine and erect positions.
- interventional cardiology
- adult intensive care
- respiratory medicine
- gastrointestinal surgery
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Footnotes
Contributors All listed authors have met the criteria for authorship set out in the ICMJE guidelines. All authors contributed to the thought, discussion, design and editing of the report. The majority of the writing of the article was done by the lead author with contributions from co-authors. All authors have given their final approval prior to submission.Specifically, both Dr DJ and Dr JB were involved directly in care and management of the patient related to this case whilst in hospital, and have followed up with the patient as well through outpatient department. They were involved in diagnosis and coordination of management of this patient’s care. Both Dr DJ and Dr JB have provided oversight and supervision in relation to the outline of the submitted case report. They have also contributed to revision and editing of draft copies of the case report as well. They have offered their opinions and guidance into the direction and content of the submitted article.Dr Riddles, as lead author was responsible for the majority of the writing of the document including development of tables and images. Dr TR was also responsible for coordination of submission of the article.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.