Pulsatile Liver: Causes & Reasons

Possible Causes for Pulsatile Liver

liver, a loud pulmonic component of the 2nd heart sound, or evidence of venous thrombosis. [clinicaladvisor.com]

Hepatojugular reflux and pulsatile liver are signs of RV failure with systemic venous congestion. In severe disease, ascites can also be present. [emedicine.medscape.com]

[…] sickle cell crisis, pre-existing pulmonary hypertension; chronic lung disease; or following cardiac surgery Physical examination may reveal distended neck veins, a tender, pulsatile [clinicaladvisor.com]

Tricuspid Valve Insufficiency

Fatigue, weakness, shortness of breath, jugular vein distension, ascites, hepato-splenomegaly, pulsatile liver, pleural effusions and peripheral oedema may be present. [escardio.org]

With severe TR, there may be an enlarged liver detected on palpation of the right upper quadrant of the abdomen; the liver may be pulsatile on palpation and even on inspection [en.wikipedia.org]

The liver may be large and pulsatile. There is usually a single first heart sound that may be increased in intensity. [patient.info]

Chronic Right-Sided Congestive Heart Failure

Hepatomegaly ± liver pulsatility if there is significant associated tricuspid regurgitation. Jaundice in advanced cases. Ascites in advanced cases. [patient.info]

liver palpable below the right costal margin; abdominal swelling and ascites; and visible elevation of the jugular venous pressure, sometimes with large a or v waves that [merckmanuals.com]

[…] include nontender peripheral pitting edema (digital pressure leaves visible and palpable imprints, sometimes quite deep) in the feet and ankles; an enlarged and sometimes pulsatile [merckmanuals.com]

Eisenmenger Syndrome

liver, AV-block, erythrocytosis, hyperchromasia, truncus arteriosus, Transthoracic echocardiography, surrogate markers, aorto-pulmonary, CT angiography, glass opacification [eurekaselect.com]

A third heart sound as well as hepatosplenomegaly or a pulsatile liver occur with right heart failure. 4.2. [ncbi.nlm.nih.gov]

Shunt, atrial septal defects, persistent ductus arteriosus, Pott-shunts, hypoplasia, fatigue, paradoxical embolism, isodynamic holosystolic murmur, tricuspid regurgitation, pulsatile [eurekaselect.com]

Acute Aortic Regurgitation

Right-sided heart failure may cause ascites, congestive hepatosplenomegaly, pulsatile liver, pleural effusions, and peripheral edema. [textbookofcardiology.org]

[…] nailbed) • Palfrey’s sign ( pistol shot sounds in radial artery ) • Rosenbach’s sign (pulsations in liver) • Gerhart’s sign ( pulsations in spleen ) • Traube’s sign (Pistol [slideshare.net]

[…] head bobs with heart beat) • Corrigan’s sign ( Dancing carotids ) • Muller’s sign (systolic pulsation of uvula) • Corrigan’s pulse (water hammer pulse) • Quninckey’s sign (pulsatile [slideshare.net]

Aortic Valve Insufficiency

liver) Gerhardt's sign (enlarged spleen) Duroziez's sign (systolic and diastolic murmurs heard over the femoral artery when it is gradually compressed) Hill's sign (A ≥ 20 [doctorslounge.com]

(Watson's) Water-hammer pulse Quincke's sign (pulsation of the capillary bed in the nail) Mayen's sign (diastolic drop of BP>15 mm Hg with arm raised) Rosenbach's sign (pulsatile [doctorslounge.com]

Pulmonary Arterial Hypertension

Jugular venous distension and hepatomegaly occur with heart failure, sometimes causing a pulsatile liver later in the disease state. [clinicaladvisor.com]

Congenital Aortic Insufficiency

Abstract A 7-year-old boy diagnosed with aortic insufficiency was treated with a Ross procedure and he had an associated right intramural coronary artery. Although preoperative angiocardiography showed that the right and left coronary artery orifices were close together, a right intramural coronary artery[…] [link.springer.com]

Tricuspid Valve Disease

Hepatojugular reflux, pulsatile liver, and signs of hepatic dysfunction also may be present. [accesssurgery.mhmedical.com]

Fatigue, weakness, shortness of breath, jugular vein distension, ascites, hepato-splenomegaly, pulsatile liver, pleural effusions and peripheral oedema may be present. [escardio.org]

The liver is tender and pulsatile. [symptoma.com]

Hepatosplenic Amyloidosis

On palpation Smooth hepatomegaly Suggests: hepatitis, chronic heart failure, sarcoid, early alcoholic cirrhosis, tricuspid incompetence with a pulsatile liver. [patient.info]

Measure the hepatomegaly by percussing the upper and lower borders (will rule out causes such as emphysema which can push the liver down giving a false impression of hepatomegaly [patient.info]

Ansell-Bywaters-Elderking Syndrome

Appendicitis, chronic, detroit, gastroenterology, ascending paralysis, GBS, Guillain-Barré syndrome, acute inflammatory paralytic neuropathy, aortic regurgitation, pulsatile [saiapm.ulbsibiu.ro]

liver, bile in urine, paralysis of extensor before flexor muscles, aortic regurgitation, systolic pressure, popliteal-brachial gradient, Bozzolo sign (1887); Kahler-Bozzolo [saiapm.ulbsibiu.ro]

Cardiac Cirrhosis

Loss of pulsatility suggests longstanding liver disease or progression to cardiac cirrhosis. [ncbi.nlm.nih.gov]

A pulsatile liver can be seen with severe tricuspid regurgitation or pericardial disease-causing congestive hepatopathy. [ncbi.nlm.nih.gov]

In constrictive pericarditis causing congestive hepatopathy, hepatomegaly with a pulsatile liver and are seen Kussmaul's sign (a rise in the jugular venous pressure on inspiration [ncbi.nlm.nih.gov]

Right-Sided Bacterial Endocarditis

Other findings included jugular venous distention with a striking cardiovascular wave, a right ventricular lift, and a pulsatile liver. [consultant360.com]

Acute Cor Pulmonale

liver, a loud pulmonic component of the 2nd heart sound, or evidence of venous thrombosis. [cancertherapyadvisor.com]

liver and ascites. [phaonlineuniv.org]

Ebstein Malformation

The symptoms of right heart failure like pulsatile liver, ascites, raised jugular venous pulse are all seen in the patients. [symptoma.com]

Pulsatile liver, raised jugular venous pressure, oedema over ankles and legs, dyspnea are common findings in the patient. [symptoma.com]

Passive Congestion of the Liver

This is particularly seen in tricuspid valve incompetence, when the liver is pulsatile. [somalidoc.com]

Ware AJ: The liver when the heart fails. Gastroenterology 1978, 74 (3):627–8. PubMed Google Scholar 18. [link.springer.com]

The macroscopic appearance is described as nutmeg liver, properly called chronic passive venous congestion. [somalidoc.com]

Hypercapnic Respiratory Failure

A pulsatile liver develops if tricuspid regurgitation is severe. Ascites may occur but is unusual. The systolic murmur of tricuspid valve regurgitation may be present. [emedicine.medscape.com]

Congenital Pulmonary Valve Insufficiency

liver. [emedicine.medscape.com]

The pulsatile liver is a sign of severe regurgitation. [revespcardiol.org]

[…] regurgitation are frequently present, that is, prominent JVP with surging V waves, holosystolic murmur at the lower left sternal border (louder with inspiration), and enlarged, pulsatile [emedicine.medscape.com]

Pericardial Calcification

Abdominal examination revealed an enlarged, pulsatile liver and there was flank dullness suggestive of ascites. [gastrohep.com]

Idiopathic Scrotal Edema

Physical exam showed signs of systemic venous congestion: JVP was 14 cm above the right atrium with rapid y descent, enlarged pulsatile liver, ascites, and lower extremity [onlinejacc.org]

Right Ventricular Disorder

liver, a loud pulmonic component of the 2nd heart sound, or evidence of venous thrombosis. [clinicaladvisor.com]

liver and ascites. [phaonlineuniv.org]

liver palpable below the right costal margin; abdominal swelling and ascites; and visible elevation of the jugular venous pressure, sometimes with large a or v waves that [merckmanuals.com]

Presinusoidal Portal Hypertension

This is particularly seen in tricuspid valve incompetence, when the liver is pulsatile. [somalidoc.com]

Hepatomegaly may also be seen, but the liver parenchyma is of normal echo texture. [saudijgastro.com]

The macroscopic appearance is described as nutmeg liver, properly called chronic passive venous congestion. [somalidoc.com]

Pulmonary Valve Insufficiency

liver. [emedicine.medscape.com]

The pulsatile liver is a sign of severeregurgitation. [revespcardiol.org]

The pulsatile liver is a sign of severe regurgitation. [revespcardiol.org]

Libman-Sacks Disease

Her physical examination revealed moderate jugular venous distention, a pulsatile liver, an S 3 gallop, and a parasternal pansystolic murmur increasing with inspiration. [thij.org]

Acute Chagas Disease with Myocarditis

Physical exam will look like congestive heart failure, with jugular venous distention, pulmonary rales, peripheral edema, pulsatile liver, and perhaps a laterally displaced [clinicaladvisor.com]

Placental Transfusion Syndrome

This may include absent or reversed end-diastolic velocity (flow) in the umbilical artery, absent or reverse flow in the ductus venosus (liver), or pulsatile flow in the umbilical [fetalhealthfoundation.org]

Right Ventricular Dilatation

liver, a loud pulmonic component of the 2nd heart sound, or evidence of venous thrombosis. [clinicaladvisor.com]

Congenital Mitral Stenosis

liver Tricuspid regurgitation JVD Parasternal heave Prominent v wave Prominent a wave TR Peripheral edema Loud P2, later becomes palpable 8. [slideshare.net]

[…] transmission of the elevated left atrial pressure ↑ Pulmonary artery pressure ↑RAP & development of right sided heart failure RV hypertrophy & enlargement Hepatomegaly & Pulsatile [slideshare.net]

Sarcoid Myocarditis

Physical exam will look like congestive heart failure, with jugular venous distention, pulmonary rales, peripheral edema, pulsatile liver, and perhaps a laterally displaced [clinicaladvisor.com]

Pulmonary Valve Disease

The pulsatile liver is a sign of severe regurgitation. [revespcardiol.org]

Right-sided heart failure may cause ascites, congestive hepatosplenomegaly, pulsatile liver, pleural effusions, and peripheral edema. [textbookofcardiology.org]

The liver is enlarged with a firm edge, and pulsatile in presystole. Auscultation reveals a low-to-medium-pitched diastolic rumble with inspiratory accentuation. [revespcardiol.org]