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Case of positional dyspnoea and hypoxia secondary to intracardiac shunting
  1. Vasanth Sritharan,
  2. Thomas Forshall,
  3. Vijay Joshi and
  4. Prashanth Shetty
  1. Respiratory Medicine, Luton and Dunstable Hospital NHS Foundation Trust, Luton, UK
  1. Correspondence to Dr Vasanth Sritharan; vasanths0820{at}; Dr Prashanth Shetty; Prashanth.Shetty2{at}; Dr Vijay Joshi; Vijay.Joshi{at}


Platypnea-orthodexia syndrome (POS) is a rare but well-characterised condition where hypoxaemia and breathlessness occur while upright but resolve once recumbent. Early recognition can result in excellent outcomes for patients and can prevent unnecessary investigations for patients, especially if they present repeatedly to hospital after missed diagnosis. We present a case of a 75-year-old woman with a chronic history of breathlessness who was picked up after observations at a routine outpatient clinic. Early recognition of the POS allowed for appropriate investigations to take place identifying a patent foramen ovale (PFO). She was referred to the tertiary centre for closure of her PFO with complete resolution of her symptoms.

  • cardiovascular medicine
  • respiratory medicine

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  • Contributors VS planned and wrote the main draft of the case report. TF revised the draft document. VJ identified the case and performed literature search. PS revised the final draft document, performed literature search and was the responsible consultant on the ward.

  • 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.

  • Provenance and peer review Not commissioned; externally peer reviewed.