Platypnea-Orthodeoxia Syndrome
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Published 2017-09-02
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►👨🏫💊Antibiotics Lectures: www.medicosisperfectionalis.com/products/courses/a… ... Check out my brand new "Electrolytes" course at www.medicosisperfectionalis.com/products/course/el… and use the PROMO code: ELECTROLYTES50 to get a 50% discount. ► Right Now! You can get access to all my hand-written hematology video notes (the notes that I use on my videos) on Patreon...There is a direct link through which you can view, download, print and enjoy! Go to www.patreon.com/medicosis Pulmonary arteriovenous malformations are found in patients with liver cirrhosis, probably due to the absence of a hepatic factor.
So, liver Cirrhosis will affect the blood vessels in the lungs by 2 different mechanisms:-
1) Absence of a hepatic factor which leads to arteriovenous malformatins in the lung.
2) Production of Nitric Oxide (NO) which is vasodilatory in effect, which will dilate the arteriovenous shunts in the lungs, increasing the chance of blood passing quickly without sufficient gas exchange, which furtherly worsens the problem.
Ventilation perfusion mismatch will occur (Shunt Physiology)
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All Comments (21)
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I think this is quickly becoming my favorite channel for medical school. You cover it all so simply and thoughtfully! (glad for the winter break to have discovered you)
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When the patient, who has hepatopulmonary syndrome, is standing, the gravity agravates the shunting. And, when he lays down, the perfusion decreases (more than the ventilation), and the V/Q gets more balanced and he feels better. have i got that right?
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Pathogenesis : In cirrhosis there is decrease metabolism of NO which in turn causes vasodilation, pulmonary vasodilation will increase perfusion leading to V/Q mismatch--->Triad cirrhosis+ Shunt+hypoxia , another mechanism is decrease metabolism of androstenedione and its increase conversion to estrogen which causes opening of new capillaries with perfusion in absence of ventilation
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thank u sir ...today I wasn't able to answer properly the term orthopnea and my friend laughed at me ...I felt very embarrass and low confident ..but now i know properly and I can answer .so thank u again ..
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THANK YOU Medicosis 👏 you make it so clear
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thankyou so much, very helpful to understand pathophysiology
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I hope you still are online Doc. Id like to find your video on trepopnea but i can not.
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Helpful thank you 😍
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Man make new videos pls.... You are very Informative... Concise and spot on
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Other than the causes you mentioned in the video, can I say every diseases/condition leading to V/Q mismatch would cause platypnea-orthodeoxia syndrome?
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Really excellent explanation
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thank you for this video, i was gonna ask about this syndrome
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You are seriously good
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thanks for the video, perfectly explained. I don't get the mechanism with patent foramen ovale. It must be a change from normal left-right shunt when lying down to right - left shunt when sitting up. The shunt must change due to increased pressure in the right atrium in the upright position. I don't get why there's more pressure in the RA when upright, shouldn't it be inverse with increased RA pressure in lying position?
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When you said I'm erect and then paused. The pause killed 😂
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Your slides are taught in ain shams med school mashallah brother
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Please upload more clinical examination vedios systemwise, you are very good at...
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Amazing ❤️💐
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Please where I find discuss about orthopnea
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pulmonary emboli cause "decreased perfusion" and the symptom is platypnea, but the vasodilation of the hepatopulmonary "increases the perfusion" , but why the symptom is also platypnea
