Diagnostic Challenge of Hepatopulmonary Syndrome in a Patient with Coexisting Structural Heart Disease
Joint Authors
Mustacchia, Paul J.
Singh, Jaspreet
Hurtado-Cordovi, Jorge M.
Lipka, Seth
Shahzad, Ghulamullah
Source
Issue
Vol. 2011, Issue 2011 (31 Dec. 2011), pp.1-3, 3 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2011-09-18
Country of Publication
Egypt
No. of Pages
3
Main Subjects
Abstract EN
Hepatopulmonary syndrome (HPS) is a severe complication seen in advance liver disease.
Its prevalence among cirrhotic patients varies from 4–47 percent.
HPS exact pathogenesis remains unknown.
Patient presents with signs/symptoms of chronic liver disease, and dypsnea of variable severity.
Our patient is a 62 years old white male with a known history of chronic hepatitis C, cirrhosis, ascites, and hypothyroidism who presented to GI/liver clinic complaining of 1 episode BRBPR, and exacerbating dypsnea associated with nausea and few episodes of non-bloody vomit.
Physical exam showed, icterus, jaundice, few small spider angiomas on the chest, decrease breath sounds bilateral right more than left, and mild tachycardic.
Abdominal exam revealed mid-line scar, moderated size ventral hernia, distention, diffused tenderness, and dullness to percussion.
Laboratory result: CBC 5.2/13.2/37.6/83, LFTs 83/217/125/5.2/4.7/7.4, Pt 22.6 INR 1.9 PTT35.4.
CT scan showed liver cirrhosis, abdominal varices, and moderated ascites collection around ventral hernia.
Calculated A-a gradient was 49.5.
Echocardiography revealed patent foramen ovale (PFO) with predominant left to right shunt.
In our case, existence of paten foramen ovale (PFO) and atelectasis precludes definitive diagnosis of HPS.
Presence of cardiopulmonary shunt could be partially responsible for the patient’s dypsnea exacerbation.
American Psychological Association (APA)
Hurtado-Cordovi, Jorge M.& Lipka, Seth& Singh, Jaspreet& Shahzad, Ghulamullah& Mustacchia, Paul J.. 2011. Diagnostic Challenge of Hepatopulmonary Syndrome in a Patient with Coexisting Structural Heart Disease. Case Reports in Hepatology،Vol. 2011, no. 2011, pp.1-3.
https://search.emarefa.net/detail/BIM-468049
Modern Language Association (MLA)
Hurtado-Cordovi, Jorge M.…[et al.]. Diagnostic Challenge of Hepatopulmonary Syndrome in a Patient with Coexisting Structural Heart Disease. Case Reports in Hepatology No. 2011 (2011), pp.1-3.
https://search.emarefa.net/detail/BIM-468049
American Medical Association (AMA)
Hurtado-Cordovi, Jorge M.& Lipka, Seth& Singh, Jaspreet& Shahzad, Ghulamullah& Mustacchia, Paul J.. Diagnostic Challenge of Hepatopulmonary Syndrome in a Patient with Coexisting Structural Heart Disease. Case Reports in Hepatology. 2011. Vol. 2011, no. 2011, pp.1-3.
https://search.emarefa.net/detail/BIM-468049
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-468049