Closure of a patent foramen ovale in patients with platypnea-orthodeoxia: a rare and overlooked cause of dyspnoea and hypoxaemia

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OBJECTIVE: Platypnea-orthodeoxia is a rare cause of dyspnea and hypoxemia induced by a change from supine to upright position resulting in veno-arterial shunting, usually through a patent foramen ovale. We aimed to describe our experience with closure of a patent foramen ovale in patients with platypnea-orthodeoxia, and to increase awareness of this diagnosis.

DESIGN: Eight patients (mean age 63 ± 12 years) were identified from hospital records between 2000-2013.

RESULTS: The underlying diseases were aortic aneurism (n=3), cardiac transplantation (n=2), left ventricular dilatation (n=1), pulmonary fibrosis (n=1), and recurrent pleural/pericardial effusion (n=1). At presentation, mean oxygen saturation was 81 ± 8% in the upright position. All patients underwent transthoracic and transesophageal echocardiography. Pulmonary pressures were normal at rest in all patients. A right-to-left shunt through a patent foramen was demonstrated after changing posture from supine to sitting. Closure of the patient foramen ovale was performed uncomplicated in all patients. Mean oxygen saturation post-procedure was 96 ± 2%. All but one patient experienced marked symptom relief.

CONCLUSION: The majority of patients with platypnea-orthodeoxia can benefit from treatment of the underlying condition. In the present cohort, patients underwent uncomplicated catheter-based closure of the patient foramen ovale with subsequent improvement of oxygen saturation and symptom improvement.

TidsskriftScandinavian Cardiovascular Journal
Sider (fra-til)357-360
Antal sider4
StatusUdgivet - 10 jul. 2015

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