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- Emma Keelan, Chris Ferguson, and Rebecca Kerr.
- Belfast City Hospital, Belfast, UK ekeelan01@qub.ac.uk.
- Clin Med (Lond). 2021 May 1; 21 (3): 226227226-227.
AbstractA 60-year-old smoker with a history of liver cirrhosis and chronic obstructive pulmonary syndrome (COPD) presented with hypoxic respiratory failure. This was felt secondary to an exacerbation of COPD. Despite treatment, the patient required 10 L of oxygen to achieve saturations of 88% on ambulation. Interstitial lung disease, pulmonary emboli and pulmonary hypertension were excluded as potential aetiologies of hypoxia. Given the history of cirrhosis, hepatopulmonary syndrome was postulated. Contrast echocardiography suggested an extracardiac shunt; a technetium-99m macroaggregated albumin scan confirmed the diagnosis.© Royal College of Physicians 2021. All rights reserved.
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