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J Thorac Cardiovasc Surg 2006;132:1225-1226
© 2006 The American Association for Thoracic Surgery

Brief Communication

Platypnea–orthodeoxia syndrome combined with constrictive pericarditis after coronary artery bypass surgery

Masaki Hashimoto, MD, PhD*, Yasuhide Okawa, MD, Hiroshi Baba, MD, Yoshiyuki Nishimura, MD, Masakazu Aoki, MD

Division of Cardiovascular Surgery, Toyohashi Heart Center, Toyohashi, Aichi, Japan.

Received for publication May 24, 2006; revisions received June 21, 2006; accepted for publication July 12, 2006.

* Address for reprints: Masaki Hashimoto, MD, PhD, Division of Cardiovascular Surgery, Toyohashi Heart Center, 21-1 Gobudori, Oyama-cho, Toyohashi, 4418530, Japan. (Email: hashimoto@heart-center.or.jp).

The first 20% of the full text of this article appears below.


Figure 1
Dr Hashimoto


Clinical Summary

A 61-year-old man presented with dyspnea 3 years after coronary artery bypass surgery. He had multiple cerebral infarctions 1 year after the operation. Because pulse oximetry was 92% in room air at his physician's consultation, he started home oxygen therapy. After 3 years, his dyspnea got worse. Redo work-up, including ventilation/perfusion (V/Q) scanning and computed tomographic scanning, was done. The result of the V/Q scan was normal. Computed tomographic scanning showed an abnormal cyst above the heart. The cyst contained liquid and showed a compressed right atrium and right ventricular outflow (Figure 1). He consulted with our institution to perform an extensive work-up.


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  		Figure 1. Preoperative computed tomography revealed an abnormal cyst above the heart. The cyst compressed the right atrium and right ventricular outflow.

 
Physical examination revealed a regular pulse, a blood pressure of 103/81 mm Hg, and no murmur in cardiac auscultation. Arterial blood gas analysis in a sitting posture showed a PaO 2 of 53.8 mm Hg and a PaCO 2 of 24.6 . . . [Full Text of this Article]




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