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Monday, 10 June 2013

Q&A : Breathlessness on sitting

Q : In a young adult patient with breathlessness in sitting position, that improves on lying supine; how would you explain this if you are told that he had a cerebral stroke 2 years earlier?

A : This patient has patent foramen ovale with previous DVT and paradoxical embolus. Recurrent DVT may lead to pulmonary thrombo-embolism and decreased perfusion of the lower segments of both lungs. The latter is responsible for hypoxia (and breathlessness) which occurs in sitting position (also called platypnea).

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