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Peer-reviewedCC BY-NCRespirology case reports

A Case of Platypnea-Orthodeoxia Syndrome Caused by Patent Foramen Ovale, Accompanied by Dilated Ascending Aorta, Thoracic Kyphosis and Persistent Eustachian Valve.

  • Ayaka Kishimoto1
  • Tomohiro Namiki1
  • Yudai Ogata1
  • Hiroya Sunabe1
  • Toshihide Inui1
  • Hiroaki Ishikawa1
  • Hiroko Watanabe1
  • Chihiro Ohta2
  • Ruriko Numata3
  • Naoto Kawamatsu4
  • Tomoko Machino-Ohtsuka4
  • Tomoya Hoshi3,5
1 more authors
  • Tohru Sakamoto1
5 affiliations
  1. 1Department of Respiratory Medicine Tsukuba Memorial Hospital Tsukuba Japan.
  2. 2Department of Cardiovascular Medicine Tsukuba Memorial Hospital Tsukuba Japan.
  3. 3Department of Cardiology, International University of Health and Welfare Narita Hospital Chiba Japan.
  4. 4Department of Cardiology, Institute of Medicine University of Tsukuba Tsukuba Japan.
  5. 5Department of Cardiology, International University of Health and Welfare School of Medicine Chiba Japan.
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Abstract

We present a case of platypnea-orthodeoxia syndrome (POS) associated with patent foramen ovale (PFO). In the upright position, right atrial compression resulting from a dilated ascending aorta and thoracic kyphosis modifies the spatial alignment of the PFO, orienting it toward inferior vena cava (IVC) inflow and increasing its tendency to remain patent. Further, a prominent Eustachian valve redirected blood returning from the IVC toward the PFO and thereby promoting right-to-left shunting. The patient subsequently underwent percutaneous transcatheter PFO closure. Even 10 months after the procedure, oxygen saturation measured on room air remained stable at 99% in both supine and upright positions.

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Cite

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BibTeX
@article{kishimoto2026case,
  title = {{A Case of Platypnea-Orthodeoxia Syndrome Caused by Patent Foramen Ovale, Accompanied by Dilated Ascending Aorta, Thoracic Kyphosis and Persistent Eustachian Valve.}},
  author = {Ayaka Kishimoto and Tomohiro Namiki and Yudai Ogata and Hiroya Sunabe and Toshihide Inui and Hiroaki Ishikawa and Hiroko Watanabe and Chihiro Ohta and Ruriko Numata and Naoto Kawamatsu and Tomoko Machino-Ohtsuka and Tomoya Hoshi and Tohru Sakamoto},
  journal = {Respirology case reports},
  year = {2026},
  month = oct,
  doi = {10.1002/rcr2.70794},
  url = {https://europepmc.org/article/MED/42904128},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - A Case of Platypnea-Orthodeoxia Syndrome Caused by Patent Foramen Ovale, Accompanied by Dilated Ascending Aorta, Thoracic Kyphosis and Persistent Eustachian Valve.
AU  - Ayaka Kishimoto
AU  - Tomohiro Namiki
AU  - Yudai Ogata
AU  - Hiroya Sunabe
AU  - Toshihide Inui
AU  - Hiroaki Ishikawa
AU  - Hiroko Watanabe
AU  - Chihiro Ohta
AU  - Ruriko Numata
AU  - Naoto Kawamatsu
AU  - Tomoko Machino-Ohtsuka
AU  - Tomoya Hoshi
AU  - Tohru Sakamoto
PY  - 2026
DA  - 2026/10/20
JO  - Respirology case reports
DO  - 10.1002/rcr2.70794
UR  - https://europepmc.org/article/MED/42904128
AB  - We present a case of platypnea-orthodeoxia syndrome (POS) associated with patent foramen ovale (PFO). In the upright position, right atrial compression resulting from a dilated ascending aorta and thoracic kyphosis modifies the spatial alignment of the PFO, orienting it toward inferior vena cava (IVC) inflow and increasing its tendency to remain patent. Further, a prominent Eustachian valve redirected blood returning from the IVC toward the PFO and thereby promoting right-to-left shunting. The patient subsequently underwent percutaneous transcatheter PFO closure. Even 10 months after the procedure, oxygen saturation measured on room air remained stable at 99% in both supine and upright positions.
SN  - 2051-3380
ER  -