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Platypnea-orthodeoxia syndrome years after acute pulmonary embolism: Two consecutive cases


1 Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
2 Department of Cardiology, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
3 Department of Cardiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
4 Department of Clinical Sciences and Community Health, University of Milan, Milan; Department of Cardiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy

Correspondence Address:
Luca Allievi,
Department of Clinical Sciences and Community Health, University of Milan, Via Festa del Perdono 7, 20122 Milan
Italy
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Source of Support: None, Conflict of Interest: None

Platypnea-Orthodeoxia syndrome (POS) is a rare condition in which dyspnoea and arterial oxygen desaturation are present in the upright position, while in the supine position, they are alleviated. It is observed in the presence of an anatomical (intra- or extracardiac) communication between the right and left heart causing a right-to-left shunt. POS is most frequently caused by a patent foramen ovale (PFO) and usually, the clinical assessment and a transthoracic echocardiograms with bubble study are enough to reach the diagnosis. The only possible treatment of POS is the percutaneous closure of the defect. We describe two cases of POS due to a PFO which manifested itself years after an episode of acute pulmonary embolism (PE), a finding never reported to date in the literature. Few cases describe the relationship between PE and POS, but these conditions may be more closely related than we currently think.


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    -  Allievi L
    -  Bongarzoni A
    -  Conconi B
    -  Tumminello G
    -  Barbieri L
    -  Carugo S
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