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Portopulmonary hypertension

INTRODUCTION

Portopulmonary hypertension (PPHTN) refers to pulmonary arterial hypertension that is associated with portal hypertension; it is a well recognized complication of chronic liver disease [1-3]. In this topic review, the definition, classification, epidemiology, and pathogenesis of PPHTN are discussed. In addition, its clinical presentation, diagnosis, treatment, and prognosis are reviewed. Hepatopulmonary syndrome, a separate but related condition characterized by hypoxemic respiratory insufficiency due to increased intrapulmonary shunting, is discussed separately [1,4,5]. (See "Hepatopulmonary syndrome: Prevalence, causes, clinical manifestations, and diagnosis".)

DEFINITION

PPHTN is considered present when pulmonary arterial hypertension (PAH) exists in a patient who has coexisting portal hypertension, and no alternative cause of the PAH exists (eg, collagen vascular disease, congenital heart disease, or certain drugs) [1].

PAH is defined according to right heart catheterization [6]:

Mean pulmonary artery pressure (mPAP) >25 mmHg at rest

Pulmonary capillary wedge pressure (PCWP) <15 mmHg

                  

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Literature review current through: Jul 2014. | This topic last updated: Jun 4, 2014.
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