scholarly journals Hepatopulmonary syndrome complicated by interstitial pneumonia and obesity with normal contrast echocardiography

2021 ◽  
Vol 9 (11) ◽  
Author(s):  
Akihito Okazaki ◽  
Kensuke Fujioka
Keyword(s):  
Interstitial Pneumonia ◽  
Contrast Echocardiography ◽  
Hepatopulmonary Syndrome

scholarly journals Hepatopulmonary syndrome: an update

2009 ◽  
Vol 127 (4) ◽  
pp. 223-230 ◽  
Author(s):  
Liana Gonçalves de Macêdo ◽  
Edmundo Pessoa de Almeida Lopes
Keyword(s):  
Liver Transplantation ◽  
Contrast Echocardiography ◽  
Hepatopulmonary Syndrome ◽  
Cochrane Library ◽  
Microvascular Remodeling ◽  
Vascular Dilatation ◽  
Cirrhotic Patients ◽  
Transplant Candidates ◽  
Liver Transplant Waiting List ◽  
Worse Prognosis

Hepatopulmonary syndrome (HPS) is a clinical threesome composed of liver disease, intrapulmonary vascular dilatation (IPVD) and arterial gas abnormalities. Its occurrence has been described in up to 32% of cirrhotic candidates for liver transplantation. It also affects non-cirrhotic patients with portal hypertension. Its pathogenesis is not well defined, but an association of factors such as imbalance in the endothelin receptor response, pulmonary microvascular remodeling and genetic predisposition is thought to lead to IPVD. Diagnosis is based on imaging methods that identify these dilatations, such as contrast echocardiography or perfusion scintigraphy with 99mTc, as well as analysis of arterial gases to identify elevated alveolar-arterial differences in O2 or hypoxemia. There is no effective pharmacological treatment and complete resolution only occurs through liver transplantation. The importance of diagnosing HPS lies in prioritizing transplant candidates, since presence of HPS is associated with worse prognosis. The aim of this paper was to review the pathogenetic theories and current diagnostic criteria regarding HPS, and to critically analyze the prioritization of patients with HPS on the liver transplant waiting list. Searches were carried out in the Medline (Medical Literature Analysis and Retrieval System Online) via PubMed, Cochrane Library and Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde) databases for articles published between January 2002 and December 2007 involving adults and written either in English or in Portuguese, using the term hepatopulmonary syndrome. The studies of greatest relevance were included in the review, along with text books and articles cited in references that were obtained through the review.

Detection of hepatopulmonary syndrome in patients with liver cirrhosis using 3D contrast echocardiography

2012 ◽  
Vol 13 (1) ◽  
pp. 14-19 ◽  
Author(s):  
Rania Gaber ◽  
Dina H. Ziada ◽  
Nesreen A. Kotb ◽  
Gehan H. Abo El-Magd ◽  
Manal Hamisa
Keyword(s):  
Liver Cirrhosis ◽  
Contrast Echocardiography ◽  
Hepatopulmonary Syndrome

scholarly journals Hepatopulmonary Syndrome with Finger Clubbing

2021 ◽  
Vol 96 (3) ◽  
pp. 236-240
Author(s):  
Ho Kyung Kim ◽  
Won Ki Kim ◽  
Joo Han Kim ◽  
Jeong Woo Lee ◽  
Wook Jin Chung ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Cirrhosis ◽  
Physical Examination ◽  
Liver Transplant ◽  
Effective Treatment ◽  
Contrast Echocardiography ◽  
Hepatopulmonary Syndrome ◽  
Upright Position ◽  
Common Symptom ◽  
Arterial Oxygenation

Hepatopulmonary syndrome is a rare lung complication of liver cirrhosis, caused by pulmonary microvascular vasodilation that induces abnormal arterial oxygenation. Typical findings on physical examination are finger clubbing and cyanosis. Dyspnea is a common symptom and is worse in the upright position. Contrast echocardiography is a useful diagnostic test. Currently, the only effective treatment is liver transplantation. We report the case of a woman with cirrhosis who has hepatopulmonary syndrome with finger clubbing, confirmed by contrast echocardiography. The patient is waiting for a liver transplant.

Diagnostic utility of contrast echocardiography and lung perfusion scan in patients with hepatopulmonary syndrome

1995 ◽  
Vol 109 (4) ◽  
pp. 1283-1288 ◽  
Author(s):  
Gary A. Abrams ◽  
Carl C. Jaffe ◽  
Paul B. Hoffer ◽  
Henry J. Binder ◽  
Michael B. Fallon
Keyword(s):  
Contrast Echocardiography ◽  
Hepatopulmonary Syndrome ◽  
Lung Perfusion ◽  
Diagnostic Utility ◽  
Perfusion Scan

scholarly journals ARE THE SPIDER ANGIOMAS SKIN MARKERS OF HEPATOPULMONARY SYNDROME?

2013 ◽  
Vol 50 (3) ◽  
pp. 175-179 ◽  
Author(s):  
Americo de Oliveira SILVERIO ◽  
Dayanne Cintra GUIMARAES ◽  
Larissa Fernanda Queiroz ELIAS ◽  
Erika Oliveira MILANEZ ◽  
Silvano NAVES
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Contrast Echocardiography ◽  
Laboratory Data ◽  
Hepatopulmonary Syndrome ◽  
Blood Gases ◽  
Vascular Changes ◽  
Arterial Blood Gases ◽  
Arterial Blood ◽  
Significant Difference

Context Hepatopathies can significantly influence both veins and arteries, these changes may cause some cutaneous stigmas, such as spider angioma (SA) and some systemic vascular changes, such as those observed in hepatopulmonary syndrome (HPS). Based on this common pathophysiological root we can assume that the SA can be skin markers of HPS. Objective The objective of this study is to assess whether there is a relationship between the presence of SA and HPS. Methods Records of 40 patients with liver cirrhosis who underwent contrast echocardiography were evaluated, in which we researched the description of SA, physical examination, and other clinical and laboratory data. For diagnosis of HPS we use these signs of the disease: presence of liver disease (cirrhosis in the case), abnormalities in gas exchange by arterial blood gases, and evidence of pulmonary vasodilations by the contrast echocardiography. Results The SA were found in 21/40 (52.5%) patients and hepatopulmonary syndrome in 9/40 (22.5%). The HPS was observed in 8/21 (38.1%) of patients with SA and 1/19 (5.3%) patients were without this sign (P<0.01). We found no statistically significant difference between the SA and the presence of HPS with sex or age. Patients with SA had a higher hypoxemia [PaO2 84.8 ± 11.5 mmHg and 19.8 ± 14.7 mmHg alveolar-arterial gradient of oxygen (AAG)] than those without SA (PaO2 90.8 ± 10.7 mmHg and 10.9 ± 11.7 AAG mmHg) (P<0.05). Conclusion Our findings show a correlation between the presence of SA and HPS, suggesting that the SA may be cutaneous markers of HPS.

scholarly journals A case of hepatopulmonary syndrome

2015 ◽  
Vol 2 (2) ◽  
pp. K25-K27 ◽  
Author(s):  
James Offer ◽  
Lawrence Green ◽  
Andrew R Houghton ◽  
Jim Campbell
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Contrast Echocardiography ◽  
Hepatopulmonary Syndrome ◽  
List Type ◽  
Left Heart ◽  
Key Features ◽  
Inexpensive Procedure ◽  
Learning Points ◽  
Contrast Studies

SummaryThis report presents the case of a 42-year-old man with liver cirrhosis who presents with breathlessness. Initial investigations are unable to explain his persistent hypoxia and a diagnosis of hepatopulmonary syndrome is considered. Saline contrast echocardiography is utilised in confirming the diagnosis. Details of this case as well as practicalities in performing and interpreting saline contrast echocardiography are reviewed.Learning pointsKey features of hepatopulmonary syndrome are liver disease, hypoxia and pulmonary vascular dilatations.Saline contrast echocardiography is a simple inexpensive procedure to perform and key to confirming the diagnosis of hepatopulmonary syndrome. Detection can be improved by performing the scan in the stand-up position.Agitated saline contrast studies are more commonly performed to identify intra-cardiac shunts. Timing of contrast arrival in the left heart chambers is key to differentiating intra-cardiac shunting from extra-cardiac pulmonary transit.

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