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European Journal of Echocardiography Advance Access published online on February 20, 2008
European Journal of Echocardiography, doi:10.1093/ejechocard/jen015
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Published on behalf of the European Society of Cardiography. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Late emergence of platypnea orthodeoxia: Chiari network and atrial septal hypertrophy demonstrated with transoesophageal echocardiography

R. Shakur, A. Ryding, J. Timperley, H. Becher and P. Leeson*

Department of Cardiology, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK

Received 5 October 2007; accepted after revision 13 December 2007.

* Corresponding author. Tel: +44 1865 741166; fax: +44 1865 221111. E-mail address: paul.leeson{at}cardiov.ox.ac.uk


  Abstract

Platypnea orthodeoxia is a rare syndrome that describes breathlessness on standing that resolves on lying flat. We present a previously healthy patient who developed platypnea orthodeoxia in her eighth decade of life. Cardiovascular imaging demonstrated an atrial septal defect, extensive Chiari network and atrial septal hypertrophy. We propose the development of lipomatous atrial septal hypertophy led to altered atrial compliance and a baffle to direct flow preferentially to the left heart on standing.

Keywords: Transoesophageal echocardiography; Platypnea orthodeoxia; Chiari network; Atrial septum


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