The Pathophysiology of HPS and Porta Pulmonary Hypertension

There's a small percentage of patients that can have both conditions. And why that would occur, I truly don't know. Patients who present with pulmonary artery hypertension then suddenly begin to evolve into becoming more hypoxemic and now they suddenly are shunting. Whether that's again some sort of change in the physiology or whether it's due to our use of potent phasodilators that begins to open up these maybe channels that are pre-existing but not necessarily noticeable in the pulmonary and the pre-capillary and capillary blood vessels is really hard to know.