Position dependent dyspnea and hypoxemia

A 63-year-old man was analyzed for platypnea-orthodeoxia syndrome (POS). A complete obstruction due to bronchial carcinoma was found in the left main bronchus with bronchoscopy. After left sided pneumonectomy POS resolved completely. Historical reports suggest increased shunting through the left lun...

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Detalles Bibliográficos
Autores principales: Hoppe, Bart P.C., van Dam, Monica J.M., Dik, Hans
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10494457/
https://www.ncbi.nlm.nih.gov/pubmed/37701457
http://dx.doi.org/10.1016/j.rmcr.2023.101912
Descripción
Sumario:A 63-year-old man was analyzed for platypnea-orthodeoxia syndrome (POS). A complete obstruction due to bronchial carcinoma was found in the left main bronchus with bronchoscopy. After left sided pneumonectomy POS resolved completely. Historical reports suggest increased shunting through the left lung could occur in the upright position caused by decreased compression of the left pulmonary artery due to the central bronchial carcinoma. Partially absent hypoxic vasoconstriction was confirmed in this case and suggests (without a relevant shunt through a patent foramen ovale) this ‘historical’ hypothesis could explain the POS due to increased shunting in the upright position in this patient.

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