RT Journal Article
SR Electronic
T1 Platypnoea–orthodeoxia after left total knee replacement
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e230771
DO 10.1136/bcr-2019-230771
VO 12
IS 10
A1 Taha Almufti
A1 Franz Eversheim
A1 Brett Johnson
A1 Gabriel Ayonmigbesimi Akra
YR 2019
UL http://casereports.bmj.com/content/12/10/e230771.abstract
AB Platypnoea–orthodeoxia syndrome (POS) is a rare disorder characterised by both dyspnoea (platypnoea) and arterial desaturation (orthodeoxia) in the upright position, with improvement in the supine position. We report an unusual case in which an 82-year-old woman developed severe hypoxaemia with POS after left total knee replacement. A significant difference in alveolar–arterial blood gas oxygen tension was demonstrated, and hypoxaemia failed to respond to 100% oxygen supply. A patent foramen ovale with a right-to-left shunt was evident on transoesophageal echocardiogram employing colour Doppler and agitated normal saline studies. Interestingly, the patient’s symptoms resolved within 6 months with ongoing chest physiotherapy, without surgical or medical intervention.