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3.
Cureus ; 14(12): e32203, 2022 Dec.
Article in English | MEDLINE | ID: mdl-36620815

ABSTRACT

Platypnea-orthodeoxia syndrome (POS) is a rare condition characterized by dyspnea and hypoxia worsening in the upright position and relieved in the recumbent position. POS can result from anatomical or functional conditions that cause interatrial communication or deformity of the atrial septum. Investigations with imaging and cardiac catheterization can aid in the evaluation. In cases where POS is caused by intracardiac shunting without pulmonary hypertension, closure of the intracardiac shunt can be curative. We report a case of POS in a 54-year-old male who was treated successfully with percutaneous closure of a patent foramen ovale (PFO).

4.
Cureus ; 13(11): e20011, 2021 Nov.
Article in English | MEDLINE | ID: mdl-34987902

ABSTRACT

Abdominal angina refers to an abdominal pain that develops shortly after food intake and gradually resolves after a few hours. It is related to insufficient mesenteric blood flow to meet the intestinal demand. In the majority of cases, this syndrome is caused by atherosclerotic narrowing of the mesenteric vessels. We report the case of a 61-year-old man, with a longstanding history of hypertension, diabetes mellitus, and dyslipidemia, who presented to the emergency department with acute abdominal pain that was aggravated by food intake. The patient reported similar but milder episodes of this pain for the last three years that led him to lose significant weight because of fear of eating. Despite this classic history of abdominal angina, his condition was misdiagnosed as indigestion, and was offered symptomatic treatment only. The basic laboratory findings were within the normal limits. The patient underwent a contrast-enhanced abdominal computed tomography scan in the arterial phase which demonstrated focal proximal stenosis of the celiac trunk due to thickened median arcuate ligament. Subsequently, the median arcuate ligament was resected laparoscopically to decompress the celiac artery. The surgical operation resulted in the complete resolution of the abdominal pain. Celiac artery compression syndrome is a rare etiology of abdominal angina. Computed tomography angiography is the imaging study of choice to make the diagnosis accurately. Laparoscopic resection of the median arcuate ligament is a safe and successful approach in the management.

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