{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T18:51:40Z","timestamp":1778698300382,"version":"3.51.4"},"reference-count":20,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>Patent foramen ovale (PFO), although frequently observed in adults, rarely causes adverse clinical consequences. The most serious among them, are cryptogenic strokes and less commonly significant hypoxia resulting from right-to-left shunt (RLS). Platypnea-orthodeoxia syndrome referring to abnormal oxygenation in the upright position has been correlated with reopening of foramen ovale and acute right-to-left intracardiac shunt. We report a case of platypnea-orthodeoxia syndrome secondary to the development of RLS through a \u2018stretched\u2019 PFO, in a patient admitted to the intensive care unit with severe respiratory failure requiring mechanical ventilation. The RLS was associated with right hemidiaphragmatic elevation, without an increased interatrial pressure gradient. The patient was successfully weaned from the ventilator after the percutaneous closure of PFO through a catheter-deployed double-umbrella device, presenting a full recovery.<\/jats:p>","DOI":"10.1136\/bcr-2012-007735","type":"journal-article","created":{"date-parts":[[2012,12,10]],"date-time":"2012-12-10T12:19:19Z","timestamp":1355141959000},"page":"bcr-2012-007735","source":"Crossref","is-referenced-by-count":22,"title":["Platypnea-orthodeoxia syndrome related to right hemidiaphragmatic elevation and a \u2018stretched\u2019 patent foramen ovale"],"prefix":"10.1136","volume":"2012","author":[{"given":"Katerina","family":"Sakagianni","sequence":"first","affiliation":[{"name":"Department of Intensive Care Unit, Sismanoglion General Hospital, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Despina","family":"Evrenoglou","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Unit, Sismanoglion General Hospital, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitrios","family":"Mytas","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sismanoglion General Hospital, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manolis","family":"Vavuranakis","sequence":"additional","affiliation":[{"name":"First Department of Cardiology, Hippokration Hospital, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2012,12,10]]},"reference":[{"key":"2025082702055792000_2012.dec09_1.bcr-2012-007735.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(12)60336-X"},{"key":"2025082702055792000_2012.dec09_1.bcr-2012-007735.2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.107.6.1504"},{"key":"2025082702055792000_2012.dec09_1.bcr-2012-007735.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.08.038"},{"key":"2025082702055792000_2012.dec09_1.bcr-2012-007735.4","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(92)90210-P"},{"key":"2025082702055792000_2012.dec09_1.bcr-2012-007735.5","doi-asserted-by":"publisher","DOI":"10.1053\/euhj.1999.1944"},{"key":"2025082702055792000_2012.dec09_1.bcr-2012-007735.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrtlng.2007.09.006"},{"key":"2025082702055792000_2012.dec09_1.bcr-2012-007735.7","doi-asserted-by":"publisher","DOI":"10.1002\/1522-726X(200009)51:1<33::AID-CCD9>3.0.CO;2-5"},{"key":"2025082702055792000_2012.dec09_1.bcr-2012-007735.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2003.04.022"},{"key":"2025082702055792000_2012.dec09_1.bcr-2012-007735.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccl.2004.10.003"},{"key":"2025082702055792000_2012.dec09_1.bcr-2012-007735.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2009.01.047"},{"key":"2025082702055792000_2012.dec09_1.bcr-2012-007735.11","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1111\/j.1540-8191.1991.tb00565.x","article-title":"Platypnea-orthodeoxia: an unusual indication for surgical closure of a patent foramen ovale","volume":"6","author":"Murray","year":"1991","journal-title":"J Card Surg"},{"key":"2025082702055792000_2012.dec09_1.bcr-2012-007735.12","doi-asserted-by":"publisher","DOI":"10.1136\/thx.49.9.933"},{"key":"2025082702055792000_2012.dec09_1.bcr-2012-007735.13","doi-asserted-by":"publisher","DOI":"10.1378\/chest.120.6.2094"},{"key":"2025082702055792000_2012.dec09_1.bcr-2012-007735.14","first-page":"434","article-title":"Successful percutaneous closure of a patent foramen ovale causing hypoxia in the setting of an elevated hemidiaphragm due to Guillain-Barre syndrome","volume":"18","author":"Maholic","year":"2006","journal-title":"J Invasive Cardiol"},{"key":"2025082702055792000_2012.dec09_1.bcr-2012-007735.15","first-page":"462","article-title":"Hypoxemia secondary to right-to-left interatrial shunt through a patent foramen ovale in a patient with an elevated right hemidiaphragm","volume":"53","author":"Perkins","year":"2008","journal-title":"Respir Care"},{"key":"2025082702055792000_2012.dec09_1.bcr-2012-007735.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.euje.2006.05.003"},{"key":"2025082702055792000_2012.dec09_1.bcr-2012-007735.17","doi-asserted-by":"crossref","unstructured":"Marriott K Manins V Forshaw A . Detection of right-to-left atrial communication using agitated saline contrast imaging: experience with 1162 patients and recommendations for echocardiography. J Am Soc Echocardiogr Published Online First: 15 Oct 2012. doi:10.1016\/j.echo.2012.09.007","DOI":"10.1016\/j.echo.2012.09.007"},{"key":"2025082702055792000_2012.dec09_1.bcr-2012-007735.18","doi-asserted-by":"publisher","DOI":"10.3121\/cmr.2007.764"},{"key":"2025082702055792000_2012.dec09_1.bcr-2012-007735.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2008.12.051"},{"key":"2025082702055792000_2012.dec09_1.bcr-2012-007735.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.acvd.2009.09.009"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2012-007735","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T09:06:05Z","timestamp":1756285565000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2012-007735"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,12,10]]},"references-count":20,"alternative-id":["10.1136\/bcr-2012-007735"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2012-007735","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,12,10]]}}}