Platypnea-orthodeoxia syndrome in review: Defining a new disease?

Cardiology (Switzerland)

Volumn 123, Issue 1, 2012, Pages 15-23

  Rodrigues, Patrcia ^a,b   Palma, Paulo ^a   Sousa Pereira, Lus ^a  

^a Centro Hospitalar Universitario do Porto   (Portugal)

^b NONE   (Portugal)

Author keywords

Atrial septal defect; Orthodeoxia; Patent foramen ovale; Platypnea

Indexed keywords

AGING; AORTA ROOT; DYSPNEA; HEART ATRIUM SEPTUM DEFECT; HEART DISEASE; HEART RIGHT ATRIUM PRESSURE; HEART RIGHT LEFT SHUNT; HEART RIGHT VENTRICLE; HUMAN; KYPHOSCOLIOSIS; ONSET AGE; PATENT FORAMEN OVALE; PLATYPNEA ORTHODEOXIA SYNDROME; PRIORITY JOURNAL; REVIEW; RISK FACTOR; STANDING; TRANSIENT ISCHEMIC ATTACK;

EID: 84865590491     PISSN: 00086312     EISSN: 14219751     Source Type: Journal    
DOI: 10.1159/000339872     Document Type: Review

References (65)

1. Strunk BL, Cheitlin MD, Stulbarg MS, Schiller NB: Right-to-left interatrial shunting through a patent foramen ovale despite normal intracardiac pressures. Am J Cardiol 1987; 60: 413-415.
2. Burchell HB, Helmholz HF Jr, Wood EH: Reflex orthostatic dyspnea associated with pulmonary hypotension. Am J Physiol 1949; 159: 563-564.
3. Schnabel TG Jr, Ratto O, Kirby CK, Johnson J, Comroe JH: Postural cyanosis and angina pectoris following pneumonectomy: relief by closure of an interatrial septal defect. J Thorac Surg 1956; 32: 246-250.
4. Altman M, Robin ED: Platypnea (diffuse zone I phenomenon?). N Engl J Med 1969; 281: 1347-1348.
5. Robin ED, Laman D, Horn BR, Theodore J: Platypnea related to orthodeoxia caused by true vascular lung shunts. N Engl J Med 1976; 294: 941-943.
6. Seward JB, Hayes DL, Smith HC, et al: Platypnea-orthodeoxia: clinical profile, diagnostic workup, management, and report of seven cases. Mayo Clin Proc 1984; 59: 221-231.
7. Krowka MJ, Dickson ER, Cortese DA: Hepatopulmonary syndrome: clinical observations and lack of therapeutic response to somatostatin analogue. Chest 1993; 104: 515-521.
8. Lange PA, Stoller JK: The hepatopulmonary syndrome. Ann Intern Med 1995; 122: 521-529.
9. Sherlock S: Vasodilatation associated with hepatocellular disease: relation to functional organ failure. Gut 1990; 31: 365-367.
10. Rodriguez-Roisin R, Roca J: Hepatopulmonary syndrome: the paradigm of liver-induced hypoxaemia. Baillieres Clin Gastroenterol 1997; 11: 387-406.
11. Rodríguez-Roisin R, Krowka M: Hepatopulmonary syndrome-a liver-induced lung vascular disorder. N Engl J Med 2008; 358: 2378-2387.
12. Luo B, Liu L, Tang L, et al: Increased pulmonary vascular endothelin B receptor expression and responsiveness to endothelin-1 in cirrhotic and portal hypertensive rats: a potential mechanism in experimental hepatopulmonary syndrome. J Hepatol 2003; 38: 556-563.
13. Raffy O, Sleiman C, Vachiery F, et al: Refractory hypoxemia during liver cirrhosis. Hepatopulmonary syndrome or 'primary' pulmonary hypertension? Am J Respir Crit Care Med 1996; 153: 1169-1171.
14. Hoeper MM, Krowka MJ, Strassburg CP: Portopulmonary hypertension and hepatopulmonary syndrome. Lancet 2004; 363: 1461-1468.
15. Papiris SA, Maniati MA, Manoussakis MN, Constantopoulos SH: Orthodeoxia in amiodarone-induced acute reversible pulmonary damage. Chest 1994; 105: 965-966.
16. Ferry TG, Naum CC: Orthodeoxia-platypnea due to diabetic autonomic neuropathy. Diabetes Care 1999; 22: 857-859.
17. Fox JL, Brown E, Harrison JK, Williams J, Terry PB: Platypnea-orthodeoxia and progressive autonomic failure. Am Rev Respir Dis 1989; 140: 1802-1804.
18. DesJardin JA, Martin RJ: Platypnea in the intensive care unit. A newly described cause. Chest 1993; 104: 1308-1309.
19. Cheng TO: Platypnea-orthodeoxia syndrome: etiology, differential diagnosis, and management. Catheter Cardiovasc Interv 1999; 47: 64-66.
20. Angelini M, Lambru G, Montepietra S, Riccardi M, Zanferrari C, Bortone E: Unexplained dyspnea in an old patient with recurrent stroke: platypnea-orthodeoxia syndrome and evidence of patent foramen ovale. Neurol Sci 2010; 31: 93-94.
21. Lopez G: Platypnea-orthodeoxia syndrome. Medicina (B Aires) 2005; 65: 268-272.
22. Cheng TO: Mechanisms of platypnea-orthodeoxia: what causes water to flow uphill? Circulation 2002; 105:e47.
23. Hagen PT, Scholz DG, Edwards WD: Incidence and size of patent foramen ovale during the first 10 decades of life: an autopsy study of 965 normal hearts. Mayo Clin Proc 1984; 59: 17-20.
24. Mügge A, Daniel WG, Angermann C, et al: Atrial septal aneurysm in adult patients. A multicenter study using transthoracic and transesophageal echocardiography. Circulation 1995; 91: 2785-2792.
25. Franke A, Hanrath P: The role of atrial septal abnormalities in cryptogenic stroke-still questionable? Eur Heart J 2001; 22: 198-200.
26. Silver MD, Dorsey JS: Aneurysms of the septum primum in adults. Arch Pathol Lab Med 1978; 102: 62-65.
27. Fox ER, Picard MH, Chow CM, Levine RA, Schwamm L, Kerr AJ: Interatrial septal mobility predicts larger shunts across patent foramen ovales: an analysis with transmitral Doppler scanning. Am Heart J 2003; 145: 730-736.
28. Acharya SS, Kartan R: A case of orthodeoxia caused by an atrial septal aneurysm. Chest 2000; 118: 871-874.
29. Kedia G, Tobis J, Lee MS: Patent foramen ovale: clinical manifestations and treatment. Rev Cardiovasc Med 2008; 9: 168-173.
30. Steiner MM, Di Tullio MR, Rundek T, et al: Patent foramen ovale size and embolic brain imaging findings among patients with ischemic stroke. Stroke 1998; 29: 944-948.
31. Irwin B, Ray S: Patent foramen ovale-assessment and treatment. Cardiovasc Ther 2012; 30:e128-e135.
32. Bertaux G, Eicher JC, Petit A, Dobsák P, Wolf JE: Anatomic interaction between the aortic root and the atrial septum: a prospective echocardiographic study. J Am Soc Echocardiogr 2007; 20: 409-414.
33. Godart F, Rey C: Platypnea-orthodeoxia syndrome: a probably underestimated syndrome? Chest 2001; 119: 1624-1625.
34. Rao PS, Palacios IF, Bach RG, Bitar SR, Sideris EB: Platypnea- orthodeoxia: management by transcatheter buttoned device implantation. Catheter Cardiovasc Interv 2001; 54: 77-82.
35. Delgado G, Inglessis I, Martin-Herrero F, et al: Management of platypnea-orthodeoxia syndrome by transcatheter closure of atrial communication: hemodynamic characteristics, clinical and echocardiographic outcome. J Invasive Cardiol 2004; 16: 578-582.
36. Hashimoto M, Okawa Y, Baba H, Nishimura Y, Aoki M: Platypnea-orthodeoxia syndrome combined with constrictive pericarditis after coronary artery bypass surgery. J Thorac Cardiovasc Surg 2006; 132: 1225-1226.
37. Adolph EA, Lacy WO, Hermoni YI, Wexler LF, Javaheri S: Reversible orthodeoxia and platypnea due to right-to-left intracardiac shunting related to pericardial effusion. Ann Intern Med 1992; 116: 138-139.
38. Patel AD, Abo-Auda WS, Nekkanti R, et al: Platypnea-orthodeoxia in a patient with ostium primum atrial septal defect with normal right heart pressures. Echocardiography 2003; 20: 299-303.
39. Wright RS, Simari RD, Orszulak TA, Edwards WD, Gleich GJ, Reeder GS: Eosinophilic endomyocardial disease presenting as cyanosis, platypnea, and orthodeoxia. Ann Intern Med 1992; 117: 482-483.
40. Romero T, Covell J, Friedman WF: A comparison of pressure-volume relations of the fetal, newborn, and adult heart. Am J Physiol 1972; 222: 1285-1290.
41. Mackenzie IM, Banning A, Dyar O: Pharmacologic exposure of an occult atrial septal defect. Crit Care Med 2001; 29: 1832-1834.
42. Khouzaie TA, Busser JR: A rare cause of dyspnea and arterial hypoxemia. Chest 1997; 112: 1681-1682.
43. Lynch JJ, Schuchard GH, Gross CM, Wann LS: Prevalence of right-to-left atrial shunting in a healthy population: detection by Valsalva maneuver contrast echocardiography. Am J Cardiol 1984; 53: 1478-1480.
44. Kusunose K, Yamada H, Todoroki T, et al: Platypnea-orthodeoxia syndrome associated with patent foramen ovale and aortic ectasia. Echocardiography 2009; 26: 114-117
45. Baptista R, da Silva AM, Castro G, Monteiro P, Providência LA: Ascending aortic aneurysm and patent foremen ovale: a rare cause of platypnea-orthodeoxia. Rev Port Cardiol 2011; 30: 445-450.
46. Faller M, Kessler R, Chaouat A, Ehrhart M, Petit H, Weitzenblum E: Platypnea-orthodeoxia syndrome related to an aortic aneurysm combined with an aneurysm of the atrial septum. Chest 2000; 118: 553-557.
47. Eicher J-C, Bonniaud P, Baudouin N, et al: Hypoxaemia associated with an enlarged aortic root: a new syndrome? Heart 2005; 91: 1030-1035.
48. Bashour T, Kabbani S, Saalouke M, Cheng TO: Persistent Eustachian valve causing severe cyanosis in atrial septal defect with normal right atrial pressure. Angiology 1983; 34: 79-83.
49. Shakur R, Ryding A, Timperley J, Becher H, Leeson P: Late emergence of platypnea orthodeoxia: Chiari network and atrial septal hypertrophy demonstrated with transoesophageal echocardiography. Eur J Echocardiogr 2008; 9: 694-696.
50. Sanikommu V, Lasorda D, Poornima I: Anatomical factors triggering platypnea-orthodeoxia in adults. Clin Cardiol 2009; 32:E55-E57.
51. Teupe CH, Groenefeld GC: Platypnea-orthodeoxia due to osteoporosis and severe kyphosis: a rare cause for dyspnea and hypoxemia. Heart Int 2011; 6:e13.
52. Toffart AC, Bouvaist H, Feral V, Blin D, Pison C: Hypoxemia-orthodeoxia related to patent foramen ovale without pulmonary hypertension. Heart Lung 2008; 37: 385-389.
53. Marini C, Miniati M, Ambrosino N, et al: Dyspnea and hypoxaemia after lung surgery: the role of interatrial right-to-left shunt. Eur Respir J 2006; 28: 174-181.
54. Yalonetsky S, Nun AB, Shwartz Y, Lorber A: Transcatheter closure of a patent foramen ovale prior to a pneumonectomy to prevent platypnea syndrome. Eur J Cardiothorac Surg 2006; 29: 622-624.
55. Roxas-Timonera M, Larracas C, Gersony D, Di Tullio M, Keller A, Homma S: Patent foramen ovale presenting as platypnea-orthodeoxia: diagnosis by transesophageal echocardiography. J Am Soc Echocardiogr 2001; 14: 1039-1041.
56. Pitcher D, Fletcher P, Laszlo G, Keen G, Rees JR: Onset of right-to-left shunting through a foramen ovale in a 70-year-old woman: successful surgical treatment. Eur Heart J 1986; 7: 541-544.
57. Godart F, Rey C, Prat A, et al: Atrial right-toleft shunting causing severe hypoxaemia despite normal right-sided pressures: report of consecutive cases corrected by percutaneous closure. Eur Heart J 2000; 21: 483-489
58. Legras A, Dequin PF, Hazouard E, Doucet O, Tranquart F, Perrotin D: Right-to-left interatrial shunt in ARDS: dramatic improvement in prone position. Intensive Care Med 1999; 25: 412-414.
59. Smeenk FW, Postmus PE: Interatrial rightto-left shunting developing after pulmonary resection in the absence of elevated right-sided heart pressures: review of the literature. Chest 1993; 103: 528-531.
60. Herregods MC, Timmermans C, Frans E, Decramer M, Daenen W, De Geest H: Diagnostic value of transesophageal echocardiography in platypnea. J Am Soc Echocardiogr 1993; 6: 624-627.
61. Drighil A, El Mosalami H, Elbadaoui N, Chraibi S, Bennis A: Patent foramen ovale: a new disease? Int J Cardiol 2007; 122: 1-9.
62. DeSouza KA, Saraswat S, DeSouza SA, Rajaram V, Reddy PC, Mosley L, Tandon N: Platypnea-orthodeoxia syndrome: a diagnostic challenge. South Med J 2009; 102: 1046-1048.
63. Otto CM: Textbook of Clinical Echocardiography. Philadelphia, Saunders, 2004.
64. Kerut EK, Norfleet WT, Plotnick GD, Giles TD: Patent foramen ovale: a review of associated conditions and the impact of physiological size. J Am Coll Cardiol 2001; 38: 613-623.
65. Angelini M, Lambru G, Montepietra S, Riccardi M, Zanferrari C, Bortone E: Unexplained dyspnea in an old patient with recurrent stroke: platypnea-orthodeoxia syndrome and evidence of patent foramen ovale. Neurol Sci 2010; 31: 93-94.