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Updated: Jan 29, 2026

Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy
Published on: June 18, 2020
Chronic Hepatitis C with Cyanosis
Mahmood Alawainati1, Jawad Khamis2, Muneer Abdulla2
1Department of Family Medicine, Ministry of Health, Manama, Bahrain.
Background:
There are multiple aetiologies for dyspnea in patients with liver disease, including pneumonia, pulmonary embolism, hepatic hydrothorax, portopulmonary syndrome, and hepatopulmonary syndrome. The aim of this paper is to emphasize the importance of early diagnosis and management of hepatopulmonary syndrome.
Case Presentation:
We report a case of a 65-year-old male who was known to have chronic hepatitis C presented with one-year history of shortness of breath and cyanosis. The initial impression of pulmonary embolism was excluded by comprehensive diagnostic investigations. The correlation between the clinical picture and investigations raised the possibility of hepatopulmonary syndrome which was confirmed by contrast-enhanced transthoracic echocardiography.
Conclusions:
High suspicion is required to diagnose hepatopulmonary syndrome in patients with liver disease and hypoxemia. Screening for this complication is appropriate in liver transplant candidates, and diagnosed patients should be evaluated extensively for liver transplant.
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