Liver & GIT
Orthodeoxia is a feature of ? (PNQ)
Hepato Pulmonary Syndrome
i. It is a triad of: 1. Liver dysfunctionQ 2.Hypoxemia Q3. Intrapulmonary vascular Qdilatation.
ii. It is clinically characterized by exertional dyspnea, platypnea, clubbing and cyanosis. There is orthodeoxia – decrease in PaO2> 3mmHg when patient move from supine to standing position. Q It is characteristic of hepato pulmonary syndrome.
Definitions of orthodeoxia:
Fall in arterial blood oxygen on assuming the upright posture. Usually caused by right-to-left cardiac or vascular shunting with a posturally induced fall in left-sided pressure permitting a corresponding gradient across the shunt.
iii. The Gold standard for diagnosis is detection of right to left intrapulmonary shunts through dilatations in intrapulmonary vessels by contrast enhanced echocardiography Qor by macro aggregated albumin lungQperfusion scan.
iv. Treatment – large arterio venous shunts can be embolized.