In medicine , platypnea refers to shortness of breath dyspnea that is relieved when lying down, ref DorlandsDict six 000083340 platypnea ref and worsens when sitting or standing up. It is the opposite of orthopnea . The word is derived from the Greek language Greek platus flat and pnoia breath . Causes left atrial thrombus left atrial tumors pulmonary A V Fistula Platypnea is due to either hepatopulmonary syndrome or an anatomical cardiovascular defect increasing positional right to left shunt ing bloodflow from the right to the left part of the circulatory system . These defects include rare syndromes in which the venous blood from the liver does not pass through the lungs, or if venous blood from the portal circulation reaches the inferior vena cava without passing through the liver Abernethy malformation , type 1 . Insufficiency of abdominal muscles causes lower diaphragm position and dyspnea. In clinostatism, abdominal organs push the diaphragm in its normal, upper position, reducing the respiratory effort. Fact date May 2008 References reflist Circulatory and respiratory system symptoms and signs Category Abnormal respiration med stub es Platipnea fr Platypn e ... more details
Following are terms that specify a type of lung size and or activity. More specific definitions may be found in individual articles. Eupnea normal breathing Apnea absence of breathing Bradypnea decreased breathing rate Dyspnea or shortness of breath sensation of respiratory distress Inhalation Hyperaeration Hyperaeration Hyperinflation increased lung volume Hyperpnea fast and deep breathing Hyperventilation increased breathing that causes CO sub 2 sub loss Hypopnea slow and shallow breathing Hypoventilation decreased breathing that causes CO sub 2 sub gain Labored breathing physical presentation of respiratory distress Tachypnea increased breathing rate Orthopnea Breathlessness in lying down position relieved by sitting up or standing Platypnea Breathlessness when seated or standing, relieved by laying flat Trepopnea Breathlessness when laying flat relieved by laying in the left lateral position Ponopnea Painful breathing See also Control of respiration Circulatory and respiratory system symptoms and signs Category Lung ... more details
In medicine , hepatopulmonary syndrome is a syndrome of shortness of breath and hypoxemia low oxygen levels in the blood of the arteries caused by vasodilation broadening of the blood vessels in the lungs of patients with liver disease . Dyspnea and hypoxemia are worse in the upright position which is called platypnea and orthodeoxia , respectively . Diagnosis The hepatopulmonary syndrome is suspected in any patient with known liver disease who reports dyspnea particularly platypnea . Patients with clinically significant symptoms should undergo pulse oximetry . If the syndrome is advanced, arterial blood gas ses should be measured on air. A useful diagnostic test is contrast echocardiography . Intravenous microbubbles 10 micrometers in diameter from agitated normal saline that are normally obstructed by pulmonary capillaries normally 8 to 15 micrometers rapidly transit the lung and appear in the left atrium of the heart within 7 heart beats. Similarly, intravenous technetium 99m labeled albumin may transit the lungs and appear in the kidney and brain. Pulmonary angiography may reveal diffusely fine or blotchy vascular configuration. The distinction has to be made with an intracardiac right to left shunt . Disease mechanism The hepatopulmonary syndrome results from the formation of microscopic intrapulmonary arteriovenous dilatations in patients with both chronic and acute liver failure . The mechanism is unknown but is thought to be due to increased hepatic production or decreased hepatic clearance of vasodilator s, possibly involving nitric oxide. ref cite web last Rodr guez Roisin, MD first Roberto title Hepatopulmonary Syndrome A Liver Induced Lung Vascular Disorder url http www.nejm.org doi full 10.1056 NEJMra0707185 publisher New England Journal of Medicine accessdate 2 March 2011 ref The vascular dilatations cause overperfusion relative to ventilation, leading to ventilation perfusion mismatch and hypoxemia. There is an increased Pulmonary alveolus alveolar ar ... more details
SignSymptom infobox Name Orthopnea Image Caption DiseasesDB ICD10 ICD10 R 06 0 r 00 ICD9 ICD9 786.02 ICDO OMIM MedlinePlus eMedicineSubj eMedicineTopic MeshName MeshNumber Orthopnea or orthopnoea Greek language Greek from ortho , straight pnoia , breath is shortness of breath dyspnea which occurs when lying flat, ref DorlandsDict six 000075971 orthopnea ref causing the person to have to sleep propped up in bed or sitting in a chair. It is the opposite of platypnea . From Harrison s Principles of Internal Medicine, 17th ed., page 1446 Orthopnea is usually a later manifestation of heart failure HF than is exertional dyspnea. It results from the redistribution of fluid from the splanchnic circulation and lower extremities into the central circulation during recumbency, with a resultant increase in pulmonary capillary pressure. Nocturnal cough is a frequent manifestation of this process and a frequently overlooked symptom of HF. Orthopnea is generally relieved by sitting upright or by sleeping with additional pillows. Although orthopnea is a relatively specific symptom of HF, it may occur in patients with abdominal obesity or ascites and in patients with pulmonary disease whose lung mechanics favor an upright posture. It is commonly measured according to the number of pillows needed to prop the patient up to enable breathing Example 3 pillow orthopnea . Citation needed date December 2010 Causes Orthopnea is due to increased distribution of blood to the pulmonary circulation while recumbent, ref name urlDyspnea, Orthopnea, and Paroxysmal Nocturnal Dyspnea Clinical Methods NCBI Bookshelf cite web url http www.ncbi.nlm.nih.gov bookshelf br.fcgi?book cm&part A454 title Dyspnea, Orthopnea, and Paroxysmal Nocturnal Dyspnea Clinical Methods NCBI Bookshelf format work accessdate 2009 03 14 ref but usually can be attributed to a more fundamental cause. Orthopnea is often a symptom of Left ventricle left ventricular heart failure and or pulmonary edema . ref name pmid16899847 cit ... more details
Encyclopedia
top
