An overwhelming majority of patients with hepatopulmonary syndrome report liver problems first and eventually develop breathing issues. The most common symptom is shortness of breath (dyspnea), which can happen both when the person is at rest and exerting themselves. This occurs in over 95% of patients and usually develops years after the liver issues. The most specific complaint is platypnea, breathlessness in a sitting or standing position that improves while lying down. Some people develop a blue coloration to their skin and mucous membranes that physicians call cyanosis. Doctors can discover hypoxemia, low oxygen levels within the blood of the arteries, in patients with these symptoms.
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