platypnea

Introduction

Dyspnea in the upright position.

Etiology

• liver disease (hepatic cirrhosis)
  • hepatopulmonary syndrome
• severe pulmonary fibrosis
• 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

More general terms

• dyspnea (shortness of breath {SOB})

Additional terms

• orthodeoxia
• platypnea-orthodeoxia syndrome