扁平呼吸
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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/06/27 17:22:52」(JST)
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In medicine, platypnea refers to shortness of breath (dyspnea) that is relieved when lying down, and worsens when sitting or standing up. It is the opposite of orthopnea.[1] The word is derived from the Greek platus (= flat) and pnoia (=breath).
A related condition, orthodeoxia, describes the clinical finding of low oxygen saturation in the upright position, which improves when lying down.[2]
Platypnea and orthodeoxia often co-exist, and this combination is named platypnea-orthodeoxia syndrome.[3][4]
Causes
Platypnea is due to either hepatopulmonary syndrome or an anatomical cardiovascular defect increasing positional right-to-left shunting (bloodflow from the right to the left part of the circulatory system). These defects include rare syndromes in which the venous blood from the liver does not pass through the lungs, or if venous blood from the portal circulation reaches the inferior vena cava without passing through the liver (Abernethy malformation, type 1).
Insufficiency of abdominal muscles causes lower diaphragm position and dyspnea. In supine position, abdominal organs push the diaphragm in its normal, upper position, reducing the respiratory effort.[citation needed]
References
- ^ Dorland's Illustrated Medical Dictionary (32 ed.). Elsevier Saunders. 2012. p. 1459. ISBN 978-0-8089-2418-0.
- ^ Dorland's Illustrated Medical Dictionary (32 ed.). Elsevier Saunders. 2012. p. 1337. ISBN 978-0-8089-2418-0.
- ^ http://circ.ahajournals.org/content/105/6/e47.full
- ^ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1729301/
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Symptoms and signs: respiratory system (R04–R07, 786)
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Medical examination and history taking
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| Auscultation |
- Stethoscope
- Respiratory sounds
- Stridor
- Wheeze
- Crackles
- Rhonchi
- Hamman's sign
- Pleural friction rub
- Fremitus
- Bronchophony
- Elicited findings
- Percussion
- Pectoriloquy
- Whispered pectoriloquy
- Egophony
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| Breathing |
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Rate
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- Apnea
- Dyspnea
- Hyperventilation
- Hypoventilation
- Hyperpnea
- Tachypnea
- Hypopnea
- Bradypnea
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Pattern
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- Biot's respiration
- Cheyne–Stokes respiration
- Kussmaul breathing
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Other
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- Respiratory distress
- Respiratory arrest
- Orthopnea/Platypnea
- Trepopnea
- Asphyxia
- Breath holding
- Mouth breathing
- Snoring
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| Other |
- Chest pain
- Precordial catch syndrome
- Pleurisy
- Clubbing
- Cyanosis
- Cough
- Sputum
- Hemoptysis
- Epistaxis
- Silhouette sign
- Post-nasal drip
- Hiccup
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Index of the respiratory system
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| Description |
- Anatomy
- Physiology
- Development
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| Disease |
- Congenital
- Neoplasms and cancer
- Chest trauma
- Infection
- common cold
- pneumonia
- tuberculosis
- Other
- Symptoms and signs
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| Treatment |
- Procedures
- Drugs
- nasal
- throat
- obstructive airway diseases
- cough and cold
- histaminergics
- pulmonary arterial hypertension
- other
- Surgery
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UpToDate Contents
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English Journal
- Current Status of Percutaneous PFO Closure.
- Rohrhoff N1, Vavalle JP, Halim S, Kiefer TL, Harrison JK.Author information 1Duke University Medical Center, 3331 DUMC, Durham, NC, 27710, USA.AbstractThe clinical significance of persistent patent foramen ovale (PFO) is not well defined. Empirically, PFO has been associated with many clinical conditions. In cryptogenic stroke, migraine, and orthodeoxia/platypnea, a plausible biologic mechanism exists to support PFO closure as a possible treatment. Although transcatheter closure of PFO has been available for over 2 decades, it has remained controversial due to a paucity of evidence to guide patient and device selection. Contemporary studies investigating PFO closure as treatment for patients with these conditions have been published recently and longitudinal data regarding the safety and efficacy of the devices is now available. In this review, we aim to describe the potential clinical significance of a patent foramen in the adult, appraise the newest additions to the body of evidence, and discuss the safety, benefit, patient selection, and future of transcatheter treatment of PFO.
- Current cardiology reports.Curr Cardiol Rep.2014 May;16(5):477. doi: 10.1007/s11886-014-0477-4.
- The clinical significance of persistent patent foramen ovale (PFO) is not well defined. Empirically, PFO has been associated with many clinical conditions. In cryptogenic stroke, migraine, and orthodeoxia/platypnea, a plausible biologic mechanism exists to support PFO closure as a possible treatment
- PMID 24633647
- [Platypnea-orthodeoxia syndrome: A rare cause of severe hypoxemia.]
- Deroux A1, Chidlovskii E2, Bosc C3, Pison C3, Couturier P4.Author information 1Service de médecine aiguë gériatrique, CHU de Grenoble, BP 217, 38043 Grenoble cedex 09, France. Electronic address: aderoux@chu-grenoble.fr.2Service de médecine aiguë gériatrique, CHU de Grenoble, BP 217, 38043 Grenoble cedex 09, France.3Service de pneumologie, CHU de Grenoble, BP 217, 38043 Grenoble cedex 09, France.4Clinique universitaire de médecine gériatrique, pôle pluridisciplinaire de médecine, CHU de Grenoble, BP 217, 38043 Grenoble cedex 09, France.AbstractINTRODUCTION: The platypnea-orthodeoxia syndrome (PO) includes: (i) a dyspnea increasing with orthostatism and decreasing in supine position, (ii) wide positional range in arterial oxygen saturation with tachycardia, (iii) and hypoxemia refractory to oxygen therapy. This syndrome is usually related to a cardiac right-left shunt, and rarely to a pulmonary shunt.
- Revue de pneumologie clinique.Rev Pneumol Clin.2014 Mar 21. pii: S0761-8417(14)00017-0. doi: 10.1016/j.pneumo.2014.01.002. [Epub ahead of print]
- INTRODUCTION: The platypnea-orthodeoxia syndrome (PO) includes: (i) a dyspnea increasing with orthostatism and decreasing in supine position, (ii) wide positional range in arterial oxygen saturation with tachycardia, (iii) and hypoxemia refractory to oxygen therapy. This syndrome is usually related
- PMID 24661885
- Platypnea-orthodeoxia syndrome.
- Merino Argumánez C1, Mérida García A2, Sierra Bracamonte M2, Maestro de la Calle G2, Mateo Álvarez S2.
- Revista clinica espanola.Rev Clin Esp.2014 Mar 10. pii: S0014-2565(14)00062-9. doi: 10.1016/j.rce.2014.02.002. [Epub ahead of print]
- PMID 24625861
Japanese Journal
- Importance of Platypnea Orthodeoxia in the Differential Diagnosis of Dyspnea
- Takase Bonpei,Tanaka Yoshihiro,Hattori Hidemi,Ishihara Masayuki
- Internal Medicine 51(13), 1651-1652, 2012
- NAID 130002062219
- A Case of Platypnea Orthodeoxia Syndrome: A Persistent History Taking was the Key to the Diagnosis
- Ohfuji Takashi,Obase Yasushi,Ikeda Masaki,Obase Kikuko,Hayashida Akihiro,Okura Hiroyuki,Kobashi Yoshihiro,Yoshida Kiyoshi,Oka Mikio
- Internal Medicine 51(13), 1701-1704, 2012
- … Transesophageal echocardiography in recumbent and sitting positions revealed the platypnea orthodeoxia syndrome associated with atrial septal defect. …
- NAID 130002062209
- 卵円孔を介する platypnea orthodeoxia syndrome の1例
- 木村 舞,秋間 崇,大畑 有希子,石岡 宏太,影山 智己,長友 祐司,神吉 秀明,石川 士郎,村山 晃
- 日本内科学会雑誌 100(11), 3333-3335, 2011-11-10
- NAID 10030390695
Related Links
- 2011年12月21日 ... 姿勢によって酸素飽和度が変わる、orthodeoxia（platypnea）の機序、そして、ようやく2 週間前の「今日の症例、謎の低酸素血症」の答え：肝肺症候群,滋賀医科大学 呼吸器 内科 助教の長尾大志が作っています。
- In medicine, platypnea (sometimes referred to as Platypnea-Orthodeoxia syndrome)refers to shortness of breath (dyspnea) that is relieved when lying down, and worsens when sitting or standing up. It is the opposite of orthopnea. The word is ...
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