Kyphosis leading to platypnoea-orthodeoxia: an overlooked cause for dyspnoea and desaturation

Platypnoea-orthodeoxia syndrome is a rare cause of dyspnoea and desaturation. This case report describes a 72-year-old woman with kyphosis who presented with episodic dyspnoea at rest which worsened on exertion. She had a drop in oxygen saturation in the seated position and improvement in the supine position. Bubble contrast echo showed bubble crossing within 3 cardiac cycles suggestive of intracardiac right to left shunting of blood. Transesophageal echocardiogram confirmed the presence of a patent foramen ovale. As this is an overlooked cause for dyspnoea and desaturation, awareness of this condition and its association with kyphosis is important in the evaluation.