Multiple vertebral fractures precipitate a platypnea-orthodeoxia syndrome in a patient with atrial septal defect and aortic root dilatation: When the upright position becomes intolerable

Leonarda Galiuto; Elisa Fedele; Gabriella Locorotondo; Lazzaro Paraggio; Maria Ludovica Danza; Elena DeVito; Ambra Masi; Antonio Giuseppe Rebuzzi; Filippo Crea

doi:10.1016/j.jccase.2012.04.008

Multiple vertebral fractures precipitate a platypnea-orthodeoxia syndrome in a patient with atrial septal defect and aortic root dilatation: When the upright position becomes intolerable

J Cardiol Cases. 2012 Jun 27;6(2):e45-e48. doi: 10.1016/j.jccase.2012.04.008. eCollection 2012 Aug.

Authors

Leonarda Galiuto¹, Elisa Fedele¹, Gabriella Locorotondo¹, Lazzaro Paraggio¹, Maria Ludovica Danza¹, Elena DeVito¹, Ambra Masi¹, Antonio Giuseppe Rebuzzi¹, Filippo Crea¹

Affiliation

¹ Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.

Abstract

Platypnea-orthodeoxia syndrome is a rare disease characterized by dyspnea and oxygen desaturation induced by the upright position and relieved by recumbency. We report a case of a 65-year-old woman with a recent history of traumatic hip and multiple vertebral fractures referred to our institute due to onset of severe acute dyspnea. Transthoracic and transesophageal echocardiography, conducted by intravenous administration of agitated saline contrast solution, revealed the presence of atrial septal defect (ASD) associated with an important bidirectional shunting that was right-to-left directed when the patient was in a sitting position. Surgical closure of ASD resulted in resolution of the syndrome.

Keywords: Platypnea-orthodeoxia syndrome; Postural dyspnea; Right-to-left shunt.

Publication types

Case Reports