Q: What is the pathophysiology of playtpnea in Hepatopulmonary
syndrome?
Answer: In hepatopulmonary syndrome, there is a shunting and V/Q mismatch due to arteriovenous malformations in the lung. Platypnea and orthodeoxia occur because the pulmonary AVMs occur predominantly in the bases of the lung. Therefore, when sitting up or standing, blood pools at the bases of the lung with resultant increased AV shunting.
Answer: In hepatopulmonary syndrome, there is a shunting and V/Q mismatch due to arteriovenous malformations in the lung. Platypnea and orthodeoxia occur because the pulmonary AVMs occur predominantly in the bases of the lung. Therefore, when sitting up or standing, blood pools at the bases of the lung with resultant increased AV shunting.
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