Diagnostic Challenge of Hepatopulmonary Syndrome in a Patient with Coexisting Structural Heart Disease

Table 1

Diagnostic criteria for hepatopulmonary syndrome.

Variable	Criterion
Oxygenation defect	Partial pressure of oxygen < 80 mmHg or alveolar-arterial oxygen gradient ≥ 15 while breathing room air
Pulmonary vascular dilation	Positive findings on contrast-enhanced echocardiography or abnormal uptake in the brain (>6%) with radioactive lung-perfusion scanning
Liver disease	Portal hypertension (most common) with or without cirrhosis
Degree of severity
Mild	A-a* oxygen gradient ≥ 15, partial pressure of oxygen ≥ 80 mmHg
Moderate	A-a oxygen gradient ≥ 15, partial pressure of oxygen ≥ 60 mmHg to <80
Severe	A-a oxygen gradient ≥ 15, partial pressure of oxygen ≥ 50 mmHg to <60
Very severe	A-a oxygen gradient ≥ 15, partial pressure of oxygen < 50 mmHg

*A-a: Alveolar-arterial.
Criterion: [3].