RESUMO
We describe herein a case of a patient who, when in orthostatic positions, had severe hypoxemia and ventilatory dysfunction. Although the severity of symptoms required hospitalization in an intensive care setting, the initial tests only identified the presence of enlarged aortic root, which did not explain the condition. The association of these events with an unusual etiology, namely intracardiac shunt, characterized the diagnosis of platypnea-orthodeoxia syndrome. The literature review shows that, with advancing research methods, there was a progressive increase in the identification of this condition, and this association should be part of the differential diagnosis of dyspnea in patients with enlarged aortic root.
Assuntos
Doenças da Aorta/complicações , Dispneia/etiologia , Hipóxia/etiologia , Idoso de 80 Anos ou mais , Doenças da Aorta/diagnóstico , Doenças da Aorta/patologia , Cuidados Críticos , Diagnóstico Diferencial , Dispneia/diagnóstico , Feminino , Humanos , Hipóxia/diagnóstico , Postura , Índice de Gravidade de DoençaRESUMO
Descrevemos aqui o caso de um paciente que, ao assumir posições de ortostatismo, apresentava hipoxemia e disfunção ventilatória grave. Embora a gravidade dos sintomas tenha determinado a necessidade de internação em ambiente de terapia intensiva, os exames iniciais identificaram apenas a presença de ectasia da aorta, sem, no entanto, justificar o quadro. A associação dessas manifestações a uma etiologia incomum, o shunt intracardíaco, caracterizou o diagnóstico da síndrome de platipneia-ortodeóxia. A revisão da literatura demonstra que, com o avanço dos métodos de investigação, houve progressivo aumento na identificação desse quadro, devendo essa associação fazer parte do diagnóstico diferencial de dispneia em pacientes com aorta ectásica.
We describe herein a case of a patient who, when in orthostatic positions, had severe hypoxemia and ventilatory dysfunction. Although the severity of symptoms required hospitalization in an intensive care setting, the initial tests only identified the presence of enlarged aortic root, which did not explain the condition. The association of these events with an unusual etiology, namely intracardiac shunt, characterized the diagnosis of platypnea-orthodeoxia syndrome. The literature review shows that, with advancing research methods, there was a progressive increase in the identification of this condition, and this association should be part of the differential diagnosis of dyspnea in patients with enlarged aortic root.
