An interesting case of positional hypoxia: the effect of multiple synergistic pathological conditions.
Journal Article
This report describes an elderly patient evaluated for generalized fatigue, dyspnea, presyncopal episodes, and positional hypoxemia. Workup revealed posturally related oxygen desaturation, a patent foramen ovale (PFO), an atrial septal aneurysm, and primary adrenal insufficiency. Normal intracardiac pressures and a right-to-left PFO shunt were present only while the patient was in the upright position. Numerous etiologies of positional right-to-left shunting associated with platypnea-orthodeoxia have been described. Despite advancements in diagnostic and treatment modalities, the pathophysiology of right-to-left shunting with normal intracardiac pressure remains elusive. This report highlights the complexity of positional right-to-left shunting in hypoxemic patients with normal intracardiac pressures and multiple synergistic medical conditions.
Full Text
Duke Authors
Cited Authors
- Tempelhof, MW; Gray, AL; Wallace, TW
Published Date
- February 2009
Published In
Volume / Issue
- 102 / 2
Start / End Page
- 211 - 213
PubMed ID
- 19139699
Pubmed Central ID
- 19139699
Electronic International Standard Serial Number (EISSN)
- 1541-8243
Digital Object Identifier (DOI)
- 10.1097/SMJ.0b013e3181889538
Language
- eng
Conference Location
- United States