Multiple vertebral fractures precipitate a platypnea-orthodeoxia syndrome in a patient with atrial septal defect and aortic root dilatation: when the upright position becomes intolerable

摘要

Platypnea-orthodeoxia syndrome is a rare disease characterized by dyspnea and oxygen\uddesaturation induced by the upright position and relieved by recumbency. We report a case of 65-\udyears old woman with a recent history of traumatic hip and multiple vertebral fractures referred to our\udInstitute due to onset of severe acute dyspnea. Trans-thoracic and trans-oesophageal\udechocardiography, conducted by intravenous administration of agitated saline contrast solution,\udrevealed the presence of Atrial Septal Defect (ASD) associated with an important bidirectional shunting\udthat was right-to-left directed when the patient was in sitting position. Surgical closure of ASD resulted\udin resolution of the syndrome