ReviewJournal of medical case reports2026
Platypnea-orthodeoxia syndrome treated by percutaneous patent foramen ovale closure: a case report and review of the literature.
Review in Journal of medical case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPlatypnea-orthodeoxia syndrome is a rare but striking clinical syndrome, usually characterized by dyspnea and hypoxemia in the upright position, which is relieved by recumbency. However, the exact prevalence remains unknown. Patent foramen ovale is most commonly associated with this syndrome. Although patent foramen ovale is a common condition, the incidence of platypnea-orthodeoxia syndrome in patients with patent foramen ovale is relatively low. Here, we report a case of a 68-year-old Chinese man with platypnea-orthodeoxia syndrome due to patent foramen ovale without pulmonary hypertension who was successfully treated with transcatheter closure. CASE PRESENTATION: A 68-year-old Chinese man presented to the emergency department with acute-onset dyspnea and hypoxemia without significant precipitating factors. Tachycardia and tachypnea were observed after the initial assessment. Transthoracic echocardiography revealed an enlarged aortic root (42 mm), mild aortic valve regurgitation, and impaired left ventricular diastolic function. No significant additional findings were observed. The patient was subsequently admitted to the Respiratory Medicine Department for further investigation. Comprehensive clinical and laboratory reevaluations revealed postural hypoxemia and dyspnea. Arterial blood gases in the upright and supine positions were as follows: partial pressure of arterial oxygen = 33/69 mmHg, partial pressure of arterial carbon dioxide = 17/22 mmHg, pH = 7.54/7.48, HCO
conclusionA high index of suspicion for platypnea-orthodeoxia syndrome is recommended for elderly patients with unexplained hypoxia and shortness of breath. Identification of the underlying mechanisms of platypnea-orthodeoxia syndrome will help determine future therapeutic options. An enlarged aortic root may be the most likely cause of right-to-left shunting in patients with patent-foramen-ovale-induced platypnea-orthodeoxia syndrome. More attention should be paid to aortic root size.
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