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日本呼吸器学会英文誌 Respiratory Investigation
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Abstract

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Article in Japanese

Case Report

A case of platypnea-orthodeoxia syndrome resulting from atrial septal defect

Takashi Ishiguroa  Noboru Takayanagia  Manabu Yamamotoa  Joshi Tsutsumib  Takashi Miyamotob  Mina Gochia  Yutaka Sugitaa 

aDepartment of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center
bDepartment of Cardiology, Saitama Cardiovascular and Respiratory Center

ABSTRACT

A 76-year-old man who had been diagnosed as having chronic bird-related hypersensitivity pneumonia had received prednisolone. His respiratory condition had been stable; however; O2 saturation measured by pulse oximeter (SpO2) was reduced to 91% (O2 1 L/min, nasal canula), but no cause could be detected on echocardiography or chest computed tomography imaging. In February 2013, he presented as an outpatient with a SpO2 of 73% (O2 4 L/min, nasal canula, sitting position). We discovered that his respiratory condition improved in a supine position, but it worsened in a sitting position, and we diagnosed him as having platypnea-orthodeoxia syndrome. Transesophageal echocardiography showed right-to-left shunting of blood flow through an atrial septal defect. In the present case, reduced lung volume resulting from chronic hypersensitivity pneumonia possibly contributing to development of the platypnea-orthodeoxia syndrome.

KEYWORDS

Platypnea  Orthodeoxia  Atial septal defect  Shunt  Chronic hypersensitivity pneumonia 

Received 2 Sep 2013 / Accepted 13 Nov 2013

AJRS, 3(2): 287-292, 2014

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