Pulmonary dysfunction

The hepatopulmonary syndrome is characterized by hypoxemia and dyspnea, which are worse in the erect position in patients with portal hypertension from chronic liver disease. Pulmonary vasodilation results in basal ventilation-perfusion mismatch. Hypoxemia is only partially responsive to supplementary oxygen. This syndrome condition is common (up to 30 per cent), and the prognosis is good. In patients with portocaval shunting, progressive pulmonary vasoconstriction with hypertension, dyspnea, and hemoptysis, and right ventricular failure may supervene. This is a rare (0.5 per cent) but serious complication with a high mortality.

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