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Previous Volume 354:1759-1760 April 20, 2006 Number 16 Next

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To the Editor: The Clinical Problem-Solving article by Hegland et al. (Dec. 1 issue)¹ concerned a case of platypnea–orthodeoxia, in which a positionally dependent intracardiac right-to-left shunt led to arterial desaturation when the patient was in the upright position but not the supine. We report a case in which the converse occurred.

An 81-year-old woman was brought to the emergency room by her neighbors, who found her lying on the floor of her apartment, markedly confused. On examination, the patient was cooperative but delirious. She was hemodynamically stable, her respiratory rate was 13 breaths per minute, and her initial oxygen . . . [Full Text of this Article]

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