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Orthopnea and fever in an elderly woman

Claudio Tana, Silvio di Carlo, Mauro Silingardi, Maria Adele Giamberardino, Francesco Cipollone, Tiziana Meschi
  • Claudio Tana
    Internal Medicine and Critical Subacute Care Unit, Medicine Geriatric-Rehabilitation Department, University-Hospital of Parma, Parma, Italy | ctana@ao.pr.it
  • Silvio di Carlo
    Geriatrics Clinic, Medicine Department, ASL Pescara, Pescara, Italy
  • Mauro Silingardi
    Internal Medicine Unit, Maggiore Hospital of Bologna, AUSL Bologna, Italy
  • Maria Adele Giamberardino
    Ce.S.I.-Met; and Geriatrics Clinic, Department of Medicine and Science of Aging, G. D’Annunzio University of Chieti, Italy
  • Francesco Cipollone
    Ce.S.I.-Met; and Geriatrics Clinic, Department of Medicine and Science of Aging, G. D’Annunzio University of Chieti; Regional Center for the Study of Atherosclerosis, Hypertension and Dyslipidemia, S.S. Annunziata Hospital, ASL Chieti, Italy
  • Tiziana Meschi
    Internal Medicine and Critical Subacute Care Unit, Medicine Geriatric-Rehabilitation Department, University-Hospital of Parma, Parma, Italy

Abstract

Orthopnea is a sensation of shortness of breath, which occurs in recumbent position and is usually improved by standing or sitting. The authors report a case of an 81-year-old woman presented to the Emergency Department with a two-week history of orthopnea, fever and low back pain resistant to analgesics. Radiological findings confirm the presence of a diafragmatic hernia, and clinicians should pay attention to any history of trauma, because their absence in symptomatic adult patients directs towards a congenital cause. A surgical repair should be promptly obtained to avoid further general and respiratory deterioration.

Keywords

Acute respiratory failure; congenital disorders; hernia; diaphragm; computed tomography.

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Submitted: 2017-09-04 15:02:09
Published: 2017-11-28 14:02:13
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Copyright (c) 2017 Claudio Tana, Silvio di Carlo, Mauro Silingardi, Maria Adele Giamberardino, Francesco Cipollone, Tiziana Meschi

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