El síndrome platipnea-ortodeoxia: claves clínicas para su sospecha en urgencias / Platypnea-orthodeoxia syndrome in Spain

RESUMEN

El síndrome de platipnea-ortodeoxia (SPO) se caracteriza por disnea e hipoxemia en ortostatismo. Su diagnóstico diferencial muestra causas cardiacas y extracardiacas responsables de distintos mecanismos fisiopatológicos. Se ha realizado una revisión desde enero de 2002 hasta junio de 2014 de los casos confirmados de SPO en el Hospital Universitario Miguel Servet de Zaragoza. Se encontraron un total de 4 casos 3 de ellos secundarios a un shunt derecha-izquierda intracardiaco a través de un foramen oval permeable (FOP) y uno secundario a un shunt vascular pulmonar en el contexto de un síndrome hepatopulmonar. Se presentan dos de estos casos y se discuten las claves clínicas para su sospecha en urgencias (AU)

ABSTRACT

Platypnea orthodeoxia (PO) syndrome is characterized by dyspnea and orthostatic hypoxemia. Various cardiac and noncardiac conditions responsible for the pathophysiological mechanisms involved in the syndrome are found during differential diagnosis. We searched the records of Hospital Universitario Miguel Servet in Saragossa for confirmed cases of PO syndrome diagnosed between January 2002 and June 2014 and found 4 cases. Three were secondary to rightto-left shunt by way of a patent foramen ovale. The fourth was secondary to an intrapulmonary vascular shunt in the context of hepatopulmonary syndrome. A total of 129 titles on PO syndrome were indexed in MEDLINE between 1979 and April 2013; 77% were published in the last 10 years. PO syndrome is under diagnosed. The evident increase in incidence in recent years is probably attributable to better diagnostic techniques (AU)