Transcript
Announcer:
You’re listening to Clinician’s Roundtable on ReachMD. On this episode, we’ll hear from Dr. Arun Jose, who’s an Associate Professor of Medicine at the University of Cincinnati College of Medicine. He’ll be discussing the clinical presentation of portopulmonary hypertension. Here’s Dr. Jose now.
Dr. Jose:
Portopulmonary hypertension is a type of pulmonary arterial hypertension that occurs exclusively in patients with underlying portal hypertensive liver disease. So there's some element of liver disease, most often liver cirrhosis, that causes elevated pressure in the portal veins. Now, these are almost always—but not always, not exclusively—patients with underlying liver cirrhosis. You can also have patients who have portal hypertension without liver cirrhosis. Sometimes there can be compression or abnormalities of the portal veins, and these patients are also at risk for developing pulmonary arterial hypertension, the portopulmonary hypertension due to liver disease.
When you have portopulmonary hypertension, you will have an element of pulmonary arterial hypertension. So you have the same signs and symptoms that are associated with other types of pulmonary arterial hypertension. Patients can often have shortness of breath. They can be fatigued. Sometimes they can have passing out spells or syncope. You can have signs and symptoms of right heart dysfunction, so you can have swelling in your extremities or in your abdomen.
The screening tools are the same for other types of pulmonary hypertension, including a transthoracic echocardiography to examine and see if there is evidence of elevated pressures inside your chest. Does there appear to be a strain on the right side of your heart? And then the confirmatory test is the same as other types of pulmonary arterial hypertension, namely a right heart catheterization to confirm that there is elevated pressure inside the chest and that there's elevated vascular resistance.
Announcer:
That was Dr. Arun Jose talking about how to identify and diagnose portopulmonary hypertension. To access this and other episodes in our series, visit Clinician’s Roundtable on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!