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platypnea
Dyspnea in the upright position.
Etiology:
1) liver disease (hepatic cirrhosis)
- hepatopulmonary syndrome
2) severe pulmonary fibrosis
3) platypnea-orthopnea syndrome
- may associated with inferior wall & right ventricular myocardial infarction with tricuspid regurgitation
- pneumonectomy in patients with patent foramen ovale
Pathology:
- increased right to left shunt in the upright position
- increased right to left shunt in the lung bases
- multiple large pulmonary arteriovenous malformations in the lung bases
- associated with orthodeoxia
Laboratory:
- arterial blood gas or pulse oximetry: orthodeoxia
Radiology:
- echocardiography with agitated saline
Management:
- treat underlying disorder
- closure of patent foramen ovale [2]
Related
orthodeoxia
platypnea-orthodeoxia syndrome
General
dyspnea (shortness of breath {SOB})
References
- Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed)
Lippincott-Raven, Philadelphia, 1998, pg 720, 817
- Medical Knowledge Self Assessment Program (MKSAP) 16, 17, 18.
American College of Physicians, Philadelphia 2012, 2015, 2018