Platypnea
or platypnoea is
shortness of breath
Shortness of breath (SOB), also medically known as dyspnea (in AmE) or dyspnoea (in BrE), is an uncomfortable feeling of not being able to breathe well enough. The American Thoracic Society defines it as "a subjective experience of breathing disc ...
(dyspnea) that is relieved when
lying down, and worsens when
sitting
Sitting is a basic action and resting position in which the body weight is supported primarily by the bony ischial tuberosities with the buttocks in contact with the ground or a horizontal surface such as a chair seat, instead of by the lower l ...
or
standing
Standing, also referred to as orthostasis, is a position in which the body is held in an ''erect'' ("orthostatic") position and supported only by the feet. Although seemingly static, the body rocks slightly back and forth from the ankle in the s ...
upright. It is the opposite of
orthopnea
Orthopnea or orthopnoea is shortness of breath (dyspnea) that occurs when lying flat, causing the person to have to sleep propped up in bed or sitting in a chair. It is commonly seen as a late manifestation of heart failure, resulting from fluid ...
. The condition was first described in 1949 and named in 1969.
A related condition, orthodeoxia, describes the clinical finding of low
oxygen saturation
Oxygen saturation (symbol SO2) is a relative measure of the concentration of oxygen that is dissolved or carried in a given medium as a proportion of the maximal concentration that can be dissolved in that medium at the given temperature. It ca ...
in the upright position, which improves when lying down.
Platypnea and orthodeoxia (low oxygen levels when in upright posture) can co-exist, and this combination is named
platypnea-orthodeoxia syndrome
Platypnea–orthodeoxia syndrome is a condition in which a person has shortness of breath and low oxygen saturations when upright (platypnea and orthodeoxia), but no symptoms when lying down. It can be caused by ventilation-perfusion mismatch, i ...
.
The syndrome is considered extremely rare however.
[
]
Causes
Platypnea is usually due to either hepatopulmonary syndrome
In medicine, hepatopulmonary syndrome is a syndrome of shortness of breath and hypoxemia (low oxygen levels in the blood of the arteries) caused by vasodilation (broadening of the blood vessels) in the lungs of patients with liver disease. Dyspnea ...
or an anatomical cardiovascular defect increasing positional right-to-left shunt A right-to-left shunt is a cardiac shunt which allows blood to flow from the right heart to the left heart. This terminology is used both for the abnormal state in humans and for normal physiological shunts in reptiles.
Clinical Significance
A r ...
ing (bloodflow from the right to the left part of the circulatory system
The blood circulatory system is a system of organs that includes the heart, blood vessels, and blood which is circulated throughout the entire body of a human or other vertebrate. It includes the cardiovascular system, or vascular system, tha ...
) such as a patent foramen ovale
Atrial septal defect (ASD) is a congenital heart defect in which blood flows between the atria (upper chambers) of the heart. Some flow is a normal condition both pre-birth and immediately post-birth via the foramen ovale; however, when this d ...
. These defects include rare syndromes in which the venous
Veins are blood vessels in humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are the pulmonary and umbilical veins, both of which carry oxygenated b ...
blood from the liver does not pass through the lungs sufficiently, or if venous blood from the portal circulation
In the circulatory system of animals, a portal venous system occurs when a capillary bed pools into another capillary bed through veins, without first going through the heart. Both capillary beds and the blood vessels that connect them are con ...
reaches the inferior vena cava
The inferior vena cava is a large vein that carries the deoxygenated blood from the lower and middle body into the right atrium of the heart. It is formed by the joining of the right and the left common iliac veins, usually at the level of the ...
without passing through the liver sufficiently ( Abernethy malformation, type 1).
Etymology and pronunciation
The word ''platypnea'' uses combining forms of '' platy-'' + '' -pnea'', from Greek
Greek may refer to:
Greece
Anything of, from, or related to Greece, a country in Southern Europe:
*Greeks, an ethnic group.
*Greek language, a branch of the Indo-European language family.
**Proto-Greek language, the assumed last common ancestor ...
''platus'' (= flat) and ''pnoia'' (=breath). See pronunciation information at ''dyspnea''.
See also
* Paroxysmal nocturnal dyspnoea
Paroxysmal nocturnal dyspnea or paroxysmal nocturnal dyspnoea (PND) is an attack of severe shortness of breath and coughing that generally occurs at night. It usually awakens the person from sleep, and may be quite frightening. PND, as well as simp ...
* Orthopnea
Orthopnea or orthopnoea is shortness of breath (dyspnea) that occurs when lying flat, causing the person to have to sleep propped up in bed or sitting in a chair. It is commonly seen as a late manifestation of heart failure, resulting from fluid ...
* Trepopnea
Trepopnea is dyspnea (shortness of breath) that is sensed while lying on one side but not on the other (lateral recumbent position). It results from disease of one lung, one major bronchus, or chronic congestive heart failure that affects only a s ...
* Bendopnea
Bendopnea is a newly described symptom, normally of heart failure, meaning shortness of breath
Shortness of breath (SOB), also medically known as dyspnea (in AmE) or dyspnoea (in BrE), is an uncomfortable feeling of not being able to breathe we ...
References
Breathing abnormalities
{{Symptom-stub