Hypovolemia Resulting in Platypnea-Orthodeoxia Syndrome.

BACKGROUND

Platypnea-orthodeoxia syndrome is a rare disease entity that is characterized by dyspnea and desaturation in the upright position that resolves when the patient is in the supine position.

CASE REPORT: An 80-year-old man presented with epistaxis but was noted to be hypoxic and was unresponsive to supplemental oxygenation. His oxygen saturation improved with supine positioning, however, which is consistent with platypnea-orthodeoxia syndrome. This improved with overnight intravenous hydration. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: In patients with hypoxia and paradoxical improvement in oxygen saturation with supine positioning, consider platypnea-orthodeoxia as a potential cause.