Summary of learning points
| Any breathless, hypoxic patient with cirrhosis should be checked for platypnoea and orthodeoxia at the bedside. |
| Hepatopulmonary syndrome is perhaps the least-recognised complication of cirrhosis. |
| Spider naevi represent a cutaneous marker for intrapulmonary shunting. |
| Hepatopulmonary syndrome is reversible and an indication for urgent liver transplantation. |