Paciente con síndrome de platipnea ortodesoxia

Platypnea-orthodeoxia Syndrome (POS) consists in the presence, of dyspnea and hypoxemia in orthostatism that submit in recumbence. Its causes can be either cardiac or pulmonary. In the first case it is due to a right to left shunt which increases in orthostatism, causing more deoxygenated blood to enter the systemic circulation. If the origin is pulmonar it can happen in vascular shunt (arterious venous pulmonary fistulas and hepatopulmonary syndrome) where gravity increases the blood flow to the bases; or it can happen in parenchimal shunts (pulmonary emphysema, pneumonectomy, pulmonary embolism or adult respiratory distress syndrome) if the pulmonar bases are particularly affected increasing the dead space because of inefficient hematosis. This syndrome is more diagnosed due not only to the improvement of the techniques but also to its inclusion within the different and possible diagnosis.