Assuntos
Displasia Arritmogênica Ventricular Direita , Idoso , Amiodarona/uso terapêutico , Antiarrítmicos/uso terapêutico , Displasia Arritmogênica Ventricular Direita/fisiopatologia , Displasia Arritmogênica Ventricular Direita/terapia , Cardioversão Elétrica , Eletrocardiografia , Humanos , MasculinoRESUMO
Platypnea-orthodeoxia is a rare syndrome characterized by the occurrence of dyspnea and hypoxemia on adoption of an upright posture (i.e., orthodeoxia) and by the absence of symptoms and hypoxemia in decubitus. This syndrome is frequently related to patent foramen ovale and right-to-left shunting. We describe two patients in whom patent foramen ovale with right-to-left shunting was observed on transthoracic and transesophageal echocardiography and who had platypnea-orthodeoxia in the absence of pulmonary disease. They underwent transcatheter closure using an Amplatz device. The echocardiographic diagnosis and closure procedure are discussed. These case reports demonstrate that closure of patent foramen ovale is an effective treatment for platypnea-orthodeoxia.
Assuntos
Cateterismo Cardíaco , Defeitos dos Septos Cardíacos/terapia , Idoso , Idoso de 80 Anos ou mais , Dispneia/etiologia , Dispneia/terapia , Feminino , Defeitos dos Septos Cardíacos/complicações , Humanos , Hipóxia/etiologia , Hipóxia/terapia , Postura , SíndromeRESUMO
La platipnea-ortodesoxia es un síndrome poco frecuente que se caracteriza por disnea e hipoxemia en situación de bipedestación, con mejoría de los síntomas y recuperación de la hipoxemia con el decúbito. La asociación de este síndrome con un foramen oval permeable y un cortocircuito derecha-izquierda es muy frecuente. Describimos 2 casos de cierre percutáneo con dispositivo Amplatzer en pacientes en las que se observó un foramen oval permeable mediante estudio ecocardiográfico transtorácico y transesofágico, con paso derecha-izquierda en reposo y tras Valsalva, en mayor cantidad en la posición de sedestación respecto al decúbito y asociado con una desaturación arterial y disnea. Estos casos demuestran que el cierre del foramen oval permeable es un tratamiento eficaz de la platipnea-ortodesoxia
Platypnea-orthodeoxia is a rare syndrome characterized by the occurrence of dyspnea and hypoxemia on adoption of an upright posture (i.e., orthodeoxia) and by the absence of symptoms and hypoxemia in decubitus. This syndrome is frequently related to patent foramen ovale and right-to-left shunting. We describe two patients in whom patent foramen ovale with right-to-left shunting was observed on transthoracic and transesophageal echocardiography and who had platypnea-orthodeoxia in the absence of pulmonary disease. They underwent transcatheter closure using an Amplatz device. The echocardiographic diagnosis and closure procedure are discussed. These case reports demonstrate that closure of patent foramen ovale is an effective treatment for platypnea-orthodeoxia
Assuntos
Feminino , Idoso , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Humanos , Forame Magno/cirurgia , Dispneia/etiologia , Dispneia/cirurgia , Hipóxia/etiologia , Hipóxia/cirurgia , Cateterismo Cardíaco/métodos , Síndrome , Ecocardiografia Transesofagiana , Gasometria , Resultado do TratamentoRESUMO
We report the clinical case of a 77-years-old woman with cardiogenic shock caused by dynamic left ventricular outflow tract (LVOT) obstruction that appeared after anterior acute myocardial infarction. Dynamic LVOT obstruction has been reported in various circumstances aside from hypertrophic obstructive cardiomyopathy, such as acute myocardial infarction. In a patient with cardiogenic shock and a heart murmur after acute myocardial infarction, an acute mechanical complication, ventricular septal defect, and acute mitral regurgitation must be ruled out because the treatment of these conditions differs completely. We describe the diagnostic and therapeutic measures used in the diagnosis and treatment of this complication.
