Disclosures: Bianca Martinez, MD: No financial relationships or conflicts of interest

Case Diagnosis: A 76-year-old woman with Platypnea-Orthodeoxia Syndrome

Case Description: A 76-year-old female developed right-sided weakness due to an acute ischemic stroke in the left frontal corona radiata. The patient was admitted for inpatient rehabilitation and noted to have intermittent exercise-induced hypoxia and dyspnea with O2 saturation 85% while sitting and 93% while supine. Serial ABGs and a TEE confirmed the diagnosis of platypnea-orthodeoxia syndrome that showed patent foramen ovale (PFO) with interatrial shunt.

Setting: acute inpatient rehabilitation hospitalAssessment/

Results: The patient subsequently underwent TEE-guided PFO closure which resolved the exercise-induced hypoxia and allowed the patient to make significant functional gains. GG0130 self-care and GG0170 mobility scores were significantly improved after the procedure. Prior to the procedure, the patient required maximal assistance for most self-care and mobility activities and could not walk 150 feet due to episodes of exercise-induced hypoxia. After the procedure, the patient was independent or at supervision level for all self-care and mobility activities and could walk 150 feet with supervision.

Discussion: Platypnea-Orthodeoxia is a rare syndrome characterized by dyspnea and hypoxia when changing from a supine to an upright position. There are varied causes of this syndrome that may not be readily recognized and may be due to persistent foramen ovale with a right-to-left shunt as described in this case.

Conclusion: Patients with platypnea-orthodeoxia syndrome due to an intracardiac shunt require closure of the PFO, which results in significantly improved exercise tolerance and functional outcomes.

Level of Evidence: Level V

« Back to AAPM&R Annual Assembly 2021

PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/platypnea-orthodeoxia-syndrome-in-a-woman-with-a-patent-foramen-ovale-a-case-report/