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Intracardiac platypnea–orthodeoxia syndrome diagnosed by forward-bending and abdominal compression
  1. Ryo Kitamura,
  2. Satoshi Yoshikawa and
  3. Takeshi Ueda
  1. Emergency and General Internal Medicine, Rakuwakai Marutamachi Hospital, Kyoto, Japan
  1. Correspondence to Dr Takeshi Ueda; take4_ueda{at}


Intracardiac platypnea–orthodeoxia syndrome (POS) is a pathological condition that leads to a reduction in oxygenation in the sitting position. The detection rate of patent foramen ovale that causes POS increases with Valsalva manoeuvre and cough. We report the case of a 92-year-old woman with POS, which could not be diagnosed in the sitting position. The Valsalva manoeuvre could not be performed because of dementia, and POS was diagnosed on the forward-bending position and abdominal compression. It was assumed that forward-bending increases the right atrial pressure by compressing the right ventricle along with elongation of the aorta, and abdominal compression increases the shunt volume by increasing the venous return. If POS is suspected in patients with dementia which cannot be diagnosed in the sitting position, forward-bending and abdominal compression, instead of the Valsalva manoeuvre, might be useful.

  • cardiovascular medicine
  • clinical diagnostic tests

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  • Contributors RK contributed to the writing of the case report for this paper. SY provided ideas for the case report. TU assisted in doing final edits.

  • 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.