In a late stage of the disease, patients start having breathing difficulty as a series of pulmonary complications ensue. Most of them have to do with fluid retention and fluid balance. First off, there’s hepatic hydrothorax, a common complication that arises when there’s an accumulation of fluid in the pleural space. It accumulates in this area as a result of portal hypertension.
There’s also a change in blood pressure in the pulmonary arteries, which is known as pulmonary hypertension. In these patients, portal hypertension represents an obstruction to the normal flow, and the heart slowly becomes unable to handle the extra pressure. In the end, the excess pressure would drain to the pulmonary circulation.
All of these changes make it difficult to breathe, and the underlying problem is detected through a computed tomography, radiograph, and even ultrasound imaging. These changes typically occur in late-stage disease, and they require urgent medical attention.