Platypnea-Orthodeoxia Syndrome

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  • Опубликовано: 30 июл 2024
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    So, liver Cirrhosis will affect the blood vessels in the lungs by 2 different mechanisms:-
    1) Absence of a hepatic factor which leads to arteriovenous malformatins in the lung.
    2) Production of Nitric Oxide (NO) which is vasodilatory in effect, which will dilate the arteriovenous shunts in the lungs, increasing the chance of blood passing quickly without sufficient gas exchange, which furtherly worsens the problem.
    Ventilation perfusion mismatch will occur (Shunt Physiology)
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Комментарии • 75

  • @fernandapasolini2825
    @fernandapasolini2825 6 лет назад +65

    When the patient, who has hepatopulmonary syndrome, is standing, the gravity agravates the shunting. And, when he lays down, the perfusion decreases (more than the ventilation), and the V/Q gets more balanced and he feels better. have i got that right?

  • @neuroxplorein
    @neuroxplorein 5 лет назад +17

    I think this is quickly becoming my favorite channel for medical school. You cover it all so simply and thoughtfully! (glad for the winter break to have discovered you)

    • @MedicosisPerfectionalis
      @MedicosisPerfectionalis  5 лет назад

      Wooow! That’s amazing...Thanks for the winter break 😁...Good luck with everything 👍👍

    • @neuroxplorein
      @neuroxplorein 5 лет назад +1

      @@MedicosisPerfectionalis Thank you so much!

    • @MedicosisPerfectionalis
      @MedicosisPerfectionalis  5 лет назад +1

      My pleasure 😇...Please consider sharing when you have time, it really helps...Thanks!

    • @neuroxplorein
      @neuroxplorein 5 лет назад +1

      @@MedicosisPerfectionalis I'll let my classmates know ;)

    • @MedicosisPerfectionalis
      @MedicosisPerfectionalis  5 лет назад

      Thanks, dear...I truly appreciate it!

  • @bhuvanmaheshwari8488
    @bhuvanmaheshwari8488 4 года назад +5

    Pathogenesis : In cirrhosis there is decrease metabolism of NO which in turn causes vasodilation, pulmonary vasodilation will increase perfusion leading to V/Q mismatch--->Triad cirrhosis+ Shunt+hypoxia , another mechanism is decrease metabolism of androstenedione and its increase conversion to estrogen which causes opening of new capillaries with perfusion in absence of ventilation

  • @F91RPG
    @F91RPG 3 года назад

    Other than the causes you mentioned in the video, can I say every diseases/condition leading to V/Q mismatch would cause platypnea-orthodeoxia syndrome?

  • @lisuush6504
    @lisuush6504 4 года назад

    thanks for the video, perfectly explained. I don't get the mechanism with patent foramen ovale. It must be a change from normal left-right shunt when lying down to right - left shunt when sitting up. The shunt must change due to increased pressure in the right atrium in the upright position. I don't get why there's more pressure in the RA when upright, shouldn't it be inverse with increased RA pressure in lying position?

  • @Hyperbole3889
    @Hyperbole3889 3 месяца назад +1

    I hope you still are online Doc. Id like to find your video on trepopnea but i can not.

  • @user-bk5be9tx6n
    @user-bk5be9tx6n 6 лет назад

    Please where I find discuss about orthopnea

  • @Pema604
    @Pema604 5 лет назад +4

    thank u sir ...today I wasn't able to answer properly the term orthopnea and my friend laughed at me ...I felt very embarrass and low confident ..but now i know properly and I can answer .so thank u again ..

    • @MedicosisPerfectionalis
      @MedicosisPerfectionalis  5 лет назад +3

      That’s excellent...Don’t be embarrassed by your friends...You will probably be more successful in the future...Keep at it 👏

  • @rabbindamtew5624
    @rabbindamtew5624 2 года назад

    THANK YOU Medicosis 👏 you make it so clear

  • @shriyakachru7130
    @shriyakachru7130 5 лет назад +1

    thankyou so much, very helpful to understand pathophysiology

  • @user-bk5be9tx6n
    @user-bk5be9tx6n 6 лет назад +1

    Helpful thank you 😍

  • @timmit379
    @timmit379 5 лет назад

    pulmonary emboli cause "decreased perfusion" and the symptom is platypnea, but the vasodilation of the hepatopulmonary "increases the perfusion" , but why the symptom is also platypnea

  • @shivanksfc
    @shivanksfc 6 лет назад +1

    Man make new videos pls.... You are very Informative... Concise and spot on

    • @MedicosisPerfectionalis
      @MedicosisPerfectionalis  6 лет назад

      Thanks a lot...I am trying my best uploading quality videos as much as I can...I will try to do more...Please share! Thanks

  • @alimbo9436
    @alimbo9436 3 года назад

    Is it possible for platypnea without orthodeoxia?

  • @utkarshbansal1291
    @utkarshbansal1291 4 года назад +1

    Really excellent explanation

  • @argumentumadbaculum
    @argumentumadbaculum 5 лет назад +1

    You are seriously good

  • @tariksebbah393
    @tariksebbah393 10 месяцев назад +1

    thank you for this video, i was gonna ask about this syndrome

  • @amanullah2399
    @amanullah2399 5 лет назад +1

    Please upload more clinical examination vedios systemwise, you are very good at...

  • @nooriar67
    @nooriar67 6 лет назад +3

    When you said I'm erect and then paused. The pause killed 😂

  • @srinivasaraosirasapalli5104
    @srinivasaraosirasapalli5104 5 лет назад +1

    thank you

  • @basma1162
    @basma1162 3 года назад

    Amazing ❤️💐

  • @majiddabboussi7006
    @majiddabboussi7006 5 лет назад +1

    thx for explanation , but if you can complete the subjects related , please

  • @reneepryor104
    @reneepryor104 5 лет назад +1

    I have this. Please what does this mean for me?

    • @skomisko
      @skomisko 5 лет назад

      You should see a doctor and tell him about your problems. Googling isn't the answer to your problems, a professional help is.

  • @ripper922
    @ripper922 5 лет назад

    I Love how you speak

  • @ohyoung16486
    @ohyoung16486 6 лет назад +1

    I couldn't figure out what is platynea before...until I watched your video.

  • @jpquinones
    @jpquinones 5 месяцев назад

    what if the patient happens to have fluids in the lungs? how do you drain it?

  • @revivebodyandsoul
    @revivebodyandsoul Год назад +1

    Thanks. Not many vids on this

  • @srinivasaraosirasapalli5104
    @srinivasaraosirasapalli5104 5 лет назад +1

    excellent

  • @varthikagupta6682
    @varthikagupta6682 2 года назад

    Pls can u explain pnd

  • @neuroxplorein
    @neuroxplorein 5 лет назад

    I've been trying to get the V/Q missmatch for so long, and no videos I've layed it out so nicely. Could you also answer this silly question: since it's a shunt, by what mechanism does the embolism cause it? Blood then bypasses that portion of the lung via some other route that has less oxygenation?

    • @MedicosisPerfectionalis
      @MedicosisPerfectionalis  5 лет назад

      Can you phrase the question in a different way? I don’t seem to understand.

    • @neuroxplorein
      @neuroxplorein 5 лет назад

      ​@@MedicosisPerfectionalis Thank you greatly for the reply! Yes, sorry, my question wasn't coming out right 😂 What I was confused about was that recurrent pulmonary embolism was a possible cause of platypnea, but a PE doesn't truly fit under the low V/Q (if I am thinking correctly), as perfusion is blocked but ventilation can still occur. Does that mean that platypnea is not necessarily caused by a shunt, or does recurrent PE lead to a shunt? Hope this question makes more sense :-)

    • @sollerajr
      @sollerajr 4 года назад +2

      @@neuroxplorein It's been a year now but I'm commenting in case you still have not had an answer to your question. I think PE would cause a high V/Q rather than a low V/Q because ventilation is not affected during PE. The problem is in the pulmonary arteries which are blocked by the clot. The portion of the lung that has blocked arteries will still have air in their alveoli but will be unutilized because there is no blood flow to that area, therefore increasing the "dead space" or an area with high Ventilation and low Perfusion, thus a high V/Q ratio. To answer your question, there are many other different causes of platypnea, and also many other different causes of shunting. Platypnea then "can" be caused by a shunt, particularly a shunt involving gravity as this video showed.

    • @neuroxplorein
      @neuroxplorein 4 года назад

      @@sollerajr Thank you!

    • @ThatsWhy-
      @ThatsWhy- 3 года назад +1

      @@neuroxplorein the shunt that is caused by PE results in hypoxia because the blood returns back to heart through another new growing blood vessels to heart but without passing through lungs. I hope i touched what makes it clear to you .

  • @aymanalhaj4732
    @aymanalhaj4732 2 года назад +1

    Why you didn't do gastrointestinal vedieos

  • @Hazem-bo2jl
    @Hazem-bo2jl Месяц назад

    Your slides are taught in ain shams med school mashallah brother

  • @Misskenny2
    @Misskenny2 6 месяцев назад +1

    I am 2000% certain i am
    Suffering with this!! What tests can I ask for???

    • @MedicosisPerfectionalis
      @MedicosisPerfectionalis  6 месяцев назад

      Platypnea is a symptom/ sign.
      A good history and physical exam should confirm it. Next step is for the doctor to try to find what the cause might be.

    • @Misskenny2
      @Misskenny2 6 месяцев назад

      Can this be something that starts and gets worse over time?
      This is wild! Seems my doctor is not educated in this, as I’ve been asking for help for some time for this and being blown off.

  • @amandalal4854
    @amandalal4854 3 года назад

    Could be more clear
    But good video, thanks

  • @morningcoffeepottery5416
    @morningcoffeepottery5416 4 года назад +1

    all definitions, no explanation

  • @paraukkhal
    @paraukkhal 4 года назад +5

    Please make videos a little fast , too slow to maintain concentration

    • @MedicosisPerfectionalis
      @MedicosisPerfectionalis  4 года назад +3

      Thanks a ton for your valuable feedback!
      I will!
      In the meantime, please click on the gear ⚙️ icon and choose 1.5x or 2x

  • @r.alquwaie1501
    @r.alquwaie1501 Месяц назад

    Why’s the attitude?

  • @dalidali2757
    @dalidali2757 2 года назад

    sleepy Dr

  • @m1.01zahranormansyah4
    @m1.01zahranormansyah4 3 года назад

    i do admit the explanation is good, and clear, but gods I want to slap u to stop unnecessary weird and too long speaking