Eric A. Adolph, MD; William O. Lacy, MD; Yitzchak I. Hermoni, MD; Laura F. Wexler, MD; Shahrokh Javaheri, MD
The rare phenomena of platypnea (dyspnea exacerbated by upright posture and relieved by recumbency) and orthodeoxia (hypoxemia exacerbated by upright posture and relieved by recumbency) have been noted to accompany pulmonary arteriovenous fistulae (1) and severe chronic obstructive lung disease (2, 3) and to occur in patients after thoracotomy (4-7).
When arteriovenous fistulae are present in the lower lobes of the lungs, the right-to-left shunt can be accentuated by gravitational forces while the patient is in the upright posture, resulting in hypoxemia (1). In patients with chronic obstructive lung disease, platypnea is caused by a decrease in pulmonary blood flow
Adolph EA, Lacy WO, Hermoni YI, Wexler LF, Javaheri S. Reversible Orthodeoxia and Platypnea Due to Right-to-Left Intracardiac Shunting Related to Pericardial Effusion. Ann Intern Med. ;116:138–139. doi: 10.7326/0003-4819-116-2-138
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Published: Ann Intern Med. 1992;116(2):138-139.
Cardiology, Pericardial Disease, Pulmonary/Critical Care.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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