R. Scott Wright, MD; Robert D. Simari, MD; Thomas A. Orszulak, MD; William D. Edwards, MD; Gerald J. Gleich, MD; Guy S. Reeder, MD
Orthodeoxia and platypnea refer to arterial desaturation and dyspnea that occur with assumption of an upright posture and are relieved by recumbency (1). We describe a unique presentation of eosinophilic endomyocardial disease as cyanosis, orthodeoxia, and platypnea, all secondary to massive right-to-left shunting across a previously asymptomatic atrial septal defect.
A 39-year-old farm laborer noted a dry cough and fatigue that quickly progressed to near syncope and rest dyspnea over an 8-week period. His arterial blood gas suggested anatomic right-to-left shunting with a Pao2 (arterial partial pressure of oxygen) of 40 mm Hg on a 100% close-fitting oxygen
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Wright RS, Simari RD, Orszulak TA, Edwards WD, Gleich GJ, Reeder GS. Eosinophilic Endomyocardial Disease Presenting as Cyanosis, Platypnea, and Orthodeoxia. Ann Intern Med. 1992;117:482–483. doi: 10.7326/0003-4819-117-6-482
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Published: Ann Intern Med. 1992;117(6):482-483.
Cardiology, Pulmonary/Critical Care.
Copyright © 2017 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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