Platypnea-Orthodeoxia Syndrome: A Rare Cause of Dyspnea

Main Article Content

Joana Freitas Ribeiro
https://orcid.org/0000-0003-1821-8334
Cátia Gorgulho
https://orcid.org/0000-0003-2090-9230
Débora Lopes
Ana Matos
https://orcid.org/0000-0002-1934-1417
Luís França
https://orcid.org/0000-0002-7762-6330
Nuno Catorze
https://orcid.org/0000-0002-1975-3438

Abstract

Platypnea-Orthodeoxia Syndrome (POS) is a rare and underdiagnosed condition characterized by dyspnea and hypoxia in the upright and sitting positions, which resolve in the supine position. The authors report the case of a 79-year-old woman with progressively worsening dyspnea over three days. In the emergency department, dyspnea and desaturation were observed, requiring increasing oxygen therapy when standing. Laboratory tests, electrocardiogram, and chest computed tomography revealed no abnormalities to explain the condition. Transthoracic and transesophageal echocardiograms identified a right-to-left shunt caused by a large atrial septal aneurysm, which was treated with closure using an Atriasept – CARDIA™ prosthesis. The procedure led to immediate symptom resolution. POS diagnosis is primarily clinical. While cardiac catheterization is the gold standard for diagnosis, echocardiography plays a crucial role in identifying the underlying etiology. Treatment depends on the cause, and this condition is associated with a good prognosis.

Article Details

How to Cite
Ribeiro, J. F., Gorgulho, C., Lopes, D., Matos, A., França, L., & Catorze, N. (2025). Platypnea-Orthodeoxia Syndrome: A Rare Cause of Dyspnea. Brazilian Journal of Case Reports, 5(1), bjcr63. https://doi.org/10.52600/2763-583X.bjcr.2025.5.1.bjcr63
Section
Clinical Case Reports
Author Biographies

Joana Freitas Ribeiro, Internal Medicine Service, Unidade Local de Saúde do Médio Tejo

Internal Medicine Service, Unidade Local de Saúde do Médio Tejo, Abrantes, Portugal.

Cátia Gorgulho, Internal Medicine Service, Unidade Local de Saúde do Médio Tejo

Internal Medicine Service, Unidade Local de Saúde do Médio Tejo, Abrantes, Portugal.

Débora Lopes, Intesive Medicine Service, Unidade Local de Saúde do Médio Tejo

Intesive Medicine Service, Unidade Local de Saúde do Médio Tejo, Abrantes, Portugal.

Ana Matos, Internal Medicine Service, Unidade Local de Saúde do Médio Tejo

Internal Medicine Service, Unidade Local de Saúde do Médio Tejo, Abrantes, Portugal.

Luís França, Intesive Medicine Service, Unidade Local de Saúde do Médio Tejo

Intesive Medicine Service, Unidade Local de Saúde do Médio Tejo, Abrantes, Portugal.

Nuno Catorze, Intesive Medicine Service, Unidade Local de Saúde do Médio Tejo

Intesive Medicine Service, Unidade Local de Saúde do Médio Tejo, Abrantes, Portugal.

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