{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T09:30:27Z","timestamp":1771061427858,"version":"3.50.1"},"reference-count":6,"publisher":"SMC Media","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>When stroke patients present with respiratory failure, the first thought that clinicians have is that it is probably related to aspiration pneumonia. However, other causes should be considered, such as intracardiac or intrapulmonary shunts, that could present with paradoxical embolism. Paradoxical embolism is a rare entity defined by the occurrence of a venous thrombotic event associated with a systemic arterial embolism. Frequently, paradoxical embolism presents with platypnoea-orthodeoxia syndrome. Platypnoea-orthodeoxia syndrome is uncommon and is characterized by dyspnoea and hypoxaemia induced by orthostatic position, where symptoms and oxygenation are relieved by recumbency. The authors report a case of a patient who presented with an ischaemic stroke and progression to platypnoea-orthodeoxia syndrome with documentation of simultaneous pulmonary embolism and pulmonary arteriovenous malformations.<\/jats:p>","DOI":"10.12890\/2021_003094","type":"journal-article","created":{"date-parts":[[2021,12,16]],"date-time":"2021-12-16T03:07:31Z","timestamp":1639624051000},"source":"Crossref","is-referenced-by-count":3,"title":["Stroke and Respiratory Failure: Mind the Shunt!"],"prefix":"10.12890","volume":"8","author":[{"given":"Diana","family":"Mano","sequence":"additional","affiliation":[{"name":"Centro Hospitalar e Universit\u00e1rio do Porto, Porto, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patr\u00edcia","family":"Campos","sequence":"additional","affiliation":[{"name":"Centro Hospitalar e Universit\u00e1rio do Porto, Porto, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno","family":"Vale","sequence":"additional","affiliation":[{"name":"Centro Hospitalar e Universit\u00e1rio do Porto, Porto, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandre","family":"Pinto","sequence":"additional","affiliation":[{"name":"Centro Hospitalar e Universit\u00e1rio do Porto, Porto, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10397","published-online":{"date-parts":[[2021,12,16]]},"reference":[{"key":"10.12890\/2021_003094_ref1","doi-asserted-by":"crossref","unstructured":"<li>Windecker S, Stortecky S, Meier B. 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Platypnea-orthodeoxia syndrome: etiology, differential diagnosis, and management. <em>Cathet Cardiovasc Interv<\/em> 1999;<strong>47<\/strong>:64\u201366.<\/li>","DOI":"10.1002\/(SICI)1522-726X(199905)47:1<64::AID-CCD15>3.3.CO;2-Y"},{"key":"10.12890\/2021_003094_ref5","doi-asserted-by":"crossref","unstructured":"<li>Swanson KL, Prakash UBS, Stanson AW. Pulmonary arteriovenous fistulas: Mayo Clinic experience, 1982\u20131997. <em>Mayo Clin Proc<\/em> 1999;<strong>74<\/strong>:671\u2013680. <\/li>","DOI":"10.4065\/74.7.671"},{"key":"10.12890\/2021_003094_ref6","doi-asserted-by":"crossref","unstructured":"<li>Majumdar S, McWilliams JP. Approach to pulmonary arteriovenous malformations: a comprehensive update. <em>J Clin Med<\/em> 2020;<strong>9<\/strong>:1927.<\/li>","DOI":"10.3390\/jcm9061927"}],"container-title":["European Journal of Case Reports in Internal Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/3094\/2931","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/3094\/2932","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/3094\/2932","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T12:13:11Z","timestamp":1755864791000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/view\/3094"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,16]]},"references-count":6,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.12890\/2021_003094","relation":{"has-manifestation":[{"id-type":"other","id":"1-80-3094-g2931","asserted-by":"subject"},{"id-type":"other","id":"1-80-3094-g2932","asserted-by":"subject"}],"is-part-of":[{"id-type":"other","id":"1-80","asserted-by":"subject"}]},"ISSN":["2284-2594"],"issn-type":[{"value":"2284-2594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,16]]},"article-number":"7"}}