Charlotte Vanhomwegen1, Olivier Taton2, Nicolas Selvais3, Olivier Vanhove2, Dimitri Leduc2. 1. CHU Erasme Hospital, Université Libre de Bruxelles, Route de Lennick 808, 1070, Brussels, Belgium. cvhomweg@gmail.com. 2. Department of Pneumology, CHU Erasme Hospital, Université Libre de Bruxelles, Bruxelles, Belgium. 3. Department of Cardiology, CHU Erasme Hospital, Université Libre de Bruxelles, Bruxelles, Belgium.
Abstract
BACKGROUND: Platypnea-orthodeoxia syndrome (POS) is a rare condition characterized by dyspnoea (platypnea) and arterial desaturation in the upright position resolved in the supine position (orthodeoxia). Intracardiac shunt, pulmonary ventilation-perfusion mismatch and others intrapulmonary abnormalities are involved. CASE PRESENTATION: We report a case of POS associated with two pathophysiological issues: one, cardiac POS caused by a patent foramen ovale (PFO) and second, pulmonary POS due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) interstitial pneumonia. POS has resolved after recovery of coronavirus disease 2019 (COVID-19) pneumonia. CONCLUSIONS: Right-to-left interatrial shunt and intrapulmonary shunt caused by SARS-CoV-2 pneumonia contributed to refractory hypoxemia and POS. Therefore, in case of COVID-19 patient with unexplained POS, the existence of PFO must be investigated.
BACKGROUND: Platypnea-orthodeoxia syndrome (POS) is a rare condition characterized by dyspnoea (platypnea) and arterial desaturation in the upright position resolved in the supine position (orthodeoxia). Intracardiac shunt, pulmonary ventilation-perfusion mismatch and others intrapulmonary abnormalities are involved. CASE PRESENTATION: We report a case of POS associated with two pathophysiological issues: one, cardiac POS caused by a patent foramen ovale (PFO) and second, pulmonary POS due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) interstitial pneumonia. POS has resolved after recovery of coronavirus disease 2019 (COVID-19) pneumonia. CONCLUSIONS: Right-to-left interatrial shunt and intrapulmonary shunt caused by SARS-CoV-2 pneumonia contributed to refractory hypoxemia and POS. Therefore, in case of COVID-19patient with unexplained POS, the existence of PFO must be investigated.
Authors: A G Rigopoulos; C Bakogiannis; R de Vecchis; S Sakellaropoulos; M Ali; M Teren; M Matiakis; C Tschoepe; M Noutsias Journal: Herz Date: 2017-09-22 Impact factor: 1.443