Eosinophilic Endomyocardial Disease Presenting as Cyanosis, Platypnea, and Orthodeoxia
Authors: R. Scott Wright, Robert D. Simari, Thomas A. Orszulak, William D. Edwards, Gerald J. Gleich, Guy S. Reeder
Journal: Annals of Internal Medicine (1992)

Brief Reports15 September 1992Eosinophilic Endomyocardial Disease Presenting as Cyanosis, Platypnea, and OrthodeoxiaR. Scott Wright, MD, Robert D. Simari, MD, Thomas A. Orszulak, MD, William D. Edwards, MD, Gerald J. Gleich, MD, Guy S. Reeder, MDR. Scott Wright, MD, Robert D. Simari, MD, Thomas A. Orszulak, MD, William D. Edwards, MD, Gerald J. Gleich, MD, Guy S. Reeder, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-117-6-482 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptOrthodeoxia and platypnea refer to arterial desaturation and dyspnea that occur with assumption of an upright posture and are relieved by recumbency (1). We describe a unique presentation of eosinophilic endomyocardial disease as cyanosis, orthodeoxia, and platypnea, all secondary to massive right-to-left shunting across a previously asymptomatic atrial septal defect.Case ReportA 39-year-old farm laborer noted a dry cough and fatigue that quickly progressed to near syncope and rest dyspnea over an 8-week period. His arterial blood gas suggested anatomic right-to-left shunting with aPao2(arterial partial pressure of oxygen) of 40 mm Hg on a 100% close-fitting oxygen...References1. SewardHayesSmithWilliamsRosenowReeder JDHDEG. Platypnea-orthodeoxia: clinical profile, diagnostic workup, management and report of seven cases. Mayo Clin Proc. 1984;59:221-31. CrossrefMedlineGoogle Scholar2. Loeffler W. Endocarditis parietalis fibroplastic mit Bluteosinophilie ein eigenartiges Karnkheitsbild. Schweiz Med Wochenschr. 1936;17:817-20. Google Scholar3. GerbauxDeBruxBennaceurLenegre AJMJ. L'endocardite parierte Fibroplastique avec eosinophile sanguine endocardite de Loeffler. Bulletins et Memoires de la Societe Medicale des Hopitaux de Paris. 1956;72:456-65. MedlineGoogle Scholar4. deMelloLiapisJureidiniNouriKephartGleich DHSSGG. Cardiac localization of eosinophil-granule major basic protein in acute necrotizing myocarditis. N Engl J Med. 1990;323:1542-5. CrossrefMedlineGoogle Scholar5. ParrilloBorerHenryWolffFauci JJWSA. The cardiovascular manifestations of the hypereosinophilic syndrome. Am J Med. 1979;67:572-82. CrossrefMedlineGoogle Scholar6. Harley J. Clinical manifestations of patients with hypereosinophilic syndrome. In: Fauci AS, moderator. The idiopathic hypereosinophilic syndrome: clinical, pathophysiologic, and therapeutic considerations. Ann Intern Med. 1982;97:78-92. MedlineGoogle Scholar7. Smith J. Hypoplastic right ventricle with eosinophilic endomyocarditis and patent foramen ovale. West J Med. 1978;129:64-7. MedlineGoogle Scholar8. FauciHarleyRobertsFerransGralnick AJWVH. The idiopathic hypereosinophilic syndrome: clinical, pathophysiologic, and therapeutic considerations. Ann Intern Med. 1982;97:78-92. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: From Mayo Clinic and Mayo Foundation, Rochester, Minnesota. For current author addresses, see end of text. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByRespiratory Rate and Abnormal Breathing PatternsThe multiple dimensions of Platypnea-Orthodeoxia syndrome: A reviewRespiratory Rate and Abnormal Breathing PatternsPlatypnea-Orthodeoxia Syndrome in Review: Defining a New Disease?Platypnea-Orthodeoxia: Bilateral Lower-Lobe Pulmonary Emboli and Review of Associated Pathophysiology and ManagementRespiratory Rate and Abnormal Breathing PatternsPlatypnea-orthodeoxia: Report of Two Cases and Review of the LiteraturePlatypnea-Orthodeoxia in a Patient With Ostium Primum Atrial Septal Defect With Normal Right Heart PressuresPlatypnea-Orthodeoxia Syndrome Related to an Aortic Aneurysm Combined With an Aneurysm of the Atrial SeptumOrthodeoxia and platypnoea after acute organophosphorus poisoning reversed by CPAP: a newly described cause and review of the literatureLaryngeal Carcinoma Presenting as Platypnea 15 September 1992Volume 117, Issue 6Page: 482-483KeywordsArterial blood gasArterial partial pressure of oxygenAtrial septal defectCardiology and cardiovascular diseasesCardiovascular diseasesDyspneaFatigueOxygenPostural controlSyncope Issue Published: 15 September 1992 PDF DownloadLoading ...