Classification and external resources
Specialty Cardiology
ICD-10 R06.0
ICD-9-CM 786.02

Orthopnea or orthopnoea is shortness of breath (dyspnea) that occurs when lying flat,[1] causing the person to have to sleep propped up in bed or sitting in a chair. It is commonly seen as a late manifestation of heart failure, resulting from fluid redistribution into the central circulation, causing an increase in pulmonary capillary pressure. It is also seen in cases of abdominal obesity or pulmonary disease.[2] Orthopnea is the opposite of platypnea, shortness of breath that worsens when sitting or standing up.


Orthopnea is due to increased distribution of blood to the pulmonary circulation while recumbent,[3] but usually can be attributed to a more fundamental cause.

Orthopnea is often a symptom of left ventricular heart failure and/or pulmonary edema.[4][3] It can also occur in those with asthma and chronic bronchitis, as well as those with sleep apnea or panic disorder. It is also associated with polycystic liver disease. From a neuromuscular perspective, orthopnea is a sign of severe diaphragmatic weakness. Under such circumstances, patients may describe shortness of breath when they bend over (e.g. when tying shoelaces).

Etymology and pronunciation

The word orthopnea uses combining forms of ortho- + -pnea, from Greek ortho, straight, regular, + pnoia, breath. See pronunciation information at dyspnea.

See also


  1. "orthopnea" at Dorland's Medical Dictionary
  2. Anthony Fauci, Eugene Braunwald, Dennis Kasper, Stephen Hauser, Dan Longo, J. Jameson, Joseph Loscalzo, (2008). Harrison's Principles of Internal Medicine, 17th ed. McGraw-Hill. ISBN 9780071466332. p.1446
  3. 1 2 Mukerji, Vaskar (1990). "Dyspnea, Orthopnea, and Paroxysmal Nocturnal Dyspnea". In Walker, H. Kenneth; Hall, W. Dallas; Hurst, J. Willis. Clinical Methods: The History, Physical, and Laboratory Examinations (3rd ed.). Butterworths. ISBN 0-407-02853-6. Retrieved 2009-03-14.
  4. Torchio R, Gulotta C, Greco-Lucchina P, et al. (August 2006). "Orthopnea and tidal expiratory flow limitation in chronic heart failure". Chest. 130 (2): 472–9. doi:10.1378/chest.130.2.472. PMID 16899847.

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