{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T14:10:08Z","timestamp":1762524608483,"version":"build-2065373602"},"reference-count":11,"publisher":"SMC Media","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0Platypnea-orthodeoxia syndrome is a rare but important cause of positional hypoxemia, typically resulting from a right-to-left shunt that may be intracardiac or intrapulmonary in origin. Case report:\u00a0We present the case of a 78-year-old woman with metastatic lung adenocarcinoma and recent mild coronavirus disease 2019 (COVID-19) who developed acute-onset platypnea-orthodeoxia syndrome during hospitalization. Diagnostic workup revealed intrapulmonary shunting in the absence of pulmonary embolism or significant parenchymal lung disease. High-resolution chest computed tomography scan showed hypervascular consolidations, while bubble contrast transthoracic echocardiography confirmed delayed appearance of microbubbles in the left heart, consistent with an intrapulmonary shunt. Conclusion:\u00a0This case highlights the complex interplay between tumour-induced intrapulmonary vascular abnormalities and possible COVID-19-related endothelial dysfunction in the development of platypnea-orthodeoxia syndrome. It emphasizes the need for heightened clinical suspicion and a multimodal diagnostic approach in patients with unexplained positional hypoxemia, especially in the setting of malignancy or recent viral infections. Diagnostic confirmation relies on imaging and shunt detection techniques, and management should be guided by the patient\u2019s overall prognosis and goals of care.<\/jats:p>","DOI":"10.12890\/2025_005732","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T14:36:17Z","timestamp":1759242977000},"source":"Crossref","is-referenced-by-count":0,"title":["Sudden-onset platypnea-orthodeoxia syndrome in a patient with lung adenocarcinoma and COVID-19 without a patent foramen ovale"],"prefix":"10.12890","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4303-1352","authenticated-orcid":false,"given":"Tanguy","family":"Espejo","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Biel\/Bienne Hospital Center, Biel\/Bienne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lize","family":"Kiakouama","sequence":"first","affiliation":[{"name":"Department of Pneumology, Biel\/Bienne Hospital Center, Biel\/Bienne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reto","family":"Etter","sequence":"first","affiliation":[{"name":"Intensive Care Unit, Biel\/Bienne Hospital Center, Biel\/Bienne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie","family":"Condrau","sequence":"first","affiliation":[{"name":"Department of Geriatrics, Biel\/Bienne Hospital Center, Biel\/Bienne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10397","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"key":"10.12890\/2025_005732_ref1","doi-asserted-by":"crossref","unstructured":"Ngaha TYS, Zhilenkova AV, Essogmo FE, Uchendu IK, Abah MO, Fossa LT, et al. 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