{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T10:04:32Z","timestamp":1760609072960,"version":"3.44.0"},"reference-count":8,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,1,30]]},"abstract":"<jats:p>This is a case of an 86-year-old woman with gradually progressive dyspnoea and hypoxaemia that occurred after a cardiac surgery. It was underdiagnosed for several years, but diagnosis was triggered by the finding of hypoxaemia even during supplemental oxygen administration when in the upright position, such as when taking a shower, that rapidly improved when the patient returned to the supine position. A thorough workup disclosed platypnoea\u2013orthodeoxia syndrome (POS) associated with right-to-left shunting through a patent foramen ovale (PFO). Percutaneous closure of the PFO was performed. After treatment, the patient\u2019s arterial oxygen saturation gradually recovered to 98% on room air while she was in the sitting position and her symptoms disappeared. Reviewing this case retrospectively, we determined that the deviation of the spine with kyphosis progression had apparently proceeded as POS worsened over time. We therefore hypothesised that kyphosis progression had played a major role in the POS progression.<\/jats:p>","DOI":"10.1136\/bcr-2017-223514","type":"journal-article","created":{"date-parts":[[2018,7,30]],"date-time":"2018-07-30T09:15:41Z","timestamp":1532942141000},"page":"bcr-2017-223514","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Platypnoea\u2013orthodeoxia syndrome exacerbated by kyphosis progression"],"prefix":"10.1136","volume":"2018","author":[{"given":"Takamasa","family":"Iwai","sequence":"first","affiliation":[{"name":"Department of Cardiology, Japan Red Cross Musashino Hospital, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8961-2390","authenticated-orcid":false,"given":"Takamichi","family":"Miyamoto","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Japan Red Cross Musashino Hospital, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryoichi","family":"Miyazaki","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Japan Red Cross Musashino Hospital, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshihiro","family":"Nozato","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Japan Red Cross Musashino Hospital, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,7,30]]},"reference":[{"key":"2025082802162672000_2018.jul27_1.bcr-2017-223514.1","first-page":"563","article-title":"Reflex orthostatic dyspnea associated with pulmonary hypotension","volume":"159","author":"Burchell","year":"1949","journal-title":"Am J Physiol"},{"key":"2025082802162672000_2018.jul27_1.bcr-2017-223514.2","doi-asserted-by":"publisher","DOI":"10.1159\/000339872"},{"key":"2025082802162672000_2018.jul27_1.bcr-2017-223514.3","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1522-726X(199905)47:1<64::AID-CCD15>3.0.CO;2-6"},{"key":"2025082802162672000_2018.jul27_1.bcr-2017-223514.4","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000046073.34261.C1"},{"key":"2025082802162672000_2018.jul27_1.bcr-2017-223514.5","first-page":"701","article-title":"The effect of patent foramen ovale closure in patients with platypnea-orthodeoxia syndrome","volume":"86","author":"Mojadidi","year":"2015","journal-title":"Catheter Cardiovasc Interv"},{"key":"2025082802162672000_2018.jul27_1.bcr-2017-223514.6","doi-asserted-by":"crossref","first-page":"35","DOI":"10.2169\/internalmedicine.53.0797","article-title":"Platypnea-orthodeoxia syndrome associated with a thoracic vertebral fracture following a car accident","volume":"53","author":"Fukuoka","year":"2014","journal-title":"Intern Med"},{"key":"2025082802162672000_2018.jul27_1.bcr-2017-223514.7","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(12)60336-X"},{"key":"2025082802162672000_2018.jul27_1.bcr-2017-223514.8","doi-asserted-by":"publisher","DOI":"10.4065\/74.9.862"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2017-223514","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:16:32Z","timestamp":1756372592000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2017-223514"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7,30]]},"references-count":8,"alternative-id":["10.1136\/bcr-2017-223514"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2017-223514","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2018,7,30]]}}}