Stroke and Intractable Hypoxia: A Diagnostic and Therapeutic Challenge in Platypnea-orthodeoxia Syndrome: A Case Report and Literature Review

Platypnea-orthodeoxia syndrome is a rare phenomenon characterized by worsening hypoxia in an upright position and normal oxygen level in a supine position, mainly present as an intracardiac shunt in patients having a patent foramen ovale (PFO). Rarely can it be caused by intrapulmonary shunt and ventilation-perfusion mismatch. The diagnosis is made primarily by a transesophageal echocardiogram. The management is by closing the shunt with percutaneous implanted closure devices or, on rare occasions, surgically. Our patient is a 73-year-old male with a known case of PFO who presented as having a stroke and intractable hypoxia managed by the closure of his PFO with immediate resolution of his orthodeoxia.