Position dependent dyspnea and hypoxemia

Respiratory Medicine Case Reports, vol. 45, pp. 101912

Abstract

A 63-year-old man was analyzed for platypnea-orthodeoxia syndrome (POS). A complete obstruction due to bronchial carcinoma was found in the left main bronchus with bronchoscopy. After left sided pneumonectomy POS resolved completely. Historical reports suggest increased shunting through the left lung could occur in the upright position caused by decreased compression of the left pulmonary artery due to the central bronchial carcinoma. Partially absent hypoxic vasoconstriction was confirmed in this case and suggests (without a relevant shunt through a patent foramen ovale) this 'historical' hypothesis could explain the POS due to increased shunting in the upright position in this patient.

Authors 3

1. Bart P.C. Hoppe corresponding Aachen

   Leiden University Medical Center

   Affiliation as printed

   Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands

2. Monica J.M. van Dam Aachen

   Alrijne Ziekenhuis

   Affiliation as printed

   Alrijne Hospital, Simon Smitweg 1, 2353 GA, Leiderdorp, the Netherlands

3. Hans Dik Aachen

   Alrijne Ziekenhuis

   Affiliation as printed

   Alrijne Hospital, Simon Smitweg 1, 2353 GA, Leiderdorp, the Netherlands