Shortness of breath in the patient with chronic liver disease.

Shortness of breath is a common complaint in those with chronic liver disease. The differential diagnosis for this complaint includes primary pulmonary disorders, systemic disorders that affect the liver and lungs, and extrahepatic manifestations of portal hypertension. Orthotopic liver transplant, when appropriate, is the most effective therapy for many patients with dyspnea and chronic liver disease, although therapies to treat the underlying complications of cirrhosis may provide relief. Shortness of breath in patients with cirrhosis often portends a poor prognosis, and these patients should be evaluated for orthotopic liver transplant because this therapy is most likely to provide long-lasting benefit.