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Orthopnea is a symptom of heart failure characterized by shortness of breath that occurs when lying flat. This happens because fluid accumulates in the lungs when the heart cannot effectively pump blood. When a person with orthopnea lies down, the fluid redistribution causes increased pressure in the pulmonary circulation, leading to difficulty breathing. This condition is often accompanied by other symptoms of heart failure, such as edema (swelling) in the extremities. Orthopnea can be a significant indicator of the severity of heart dysfunction.12

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