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Acute Congestive Hepatopathy

Acute Heart Failure, Liver Disease


Presentation

  • With transmitted central venous hypertension, the hepatojugular reflex is present, unlike in hepatic congestion due to Budd-Chiari syndrome.[msdmanuals.com]
Ascitic Fluid
  • Ascitic fluid, if present, has a high albumin content (typically 2.5 g/dL). In contrast, only 10% of patients with cirrhotic ascites have ascitic albumin levels that high.[msdmanuals.com]
Asymptomatic
  • Most patients are asymptomatic. However, moderate congestion causes right upper quadrant discomfort (due to stretching of the liver capsule) and tender hepatomegaly. Severe congestion leads to massive hepatomegaly and jaundice.[msdmanuals.com]
Splenomegaly
  • Ascites may result from the transmitted central venous hypertension; infrequently, splenomegaly results. With transmitted central venous hypertension, the hepatojugular reflex is present, unlike in hepatic congestion due to Budd-Chiari syndrome.[msdmanuals.com]
Regurgitation
  • CONSUMERS: Click here for the Consumer Version Congestive hepatopathy is diffuse venous congestion within the liver that results from right-sided heart failure (usually due to a cardiomyopathy, tricuspid regurgitation, mitral insufficiency, cor pulmonale[msdmanuals.com]
Thrombosis
  • The basis for liver cell death is probably sinusoidal thrombosis that propagates to the central veins and branches of the portal vein, causing ischemia. Most patients are asymptomatic.[msdmanuals.com]
Hypertension
  • Ascites may result from the transmitted central venous hypertension; infrequently, splenomegaly results. With transmitted central venous hypertension, the hepatojugular reflex is present, unlike in hepatic congestion due to Budd-Chiari syndrome.[msdmanuals.com]
Heart Failure
  • The liver disorder is more important as an index of the severity of heart failure than as a diagnosis by itself. Targets underlying heart failure Treatment is directed at the underlying heart failure.[msdmanuals.com]
Jaundice
  • Congestive hepatopathy is suspected in patients who have right-sided heart failure, jaundice, and tender hepatomegaly.[msdmanuals.com]
Hepatomegaly
  • However, moderate congestion causes right upper quadrant discomfort (due to stretching of the liver capsule) and tender hepatomegaly. Severe congestion leads to massive hepatomegaly and jaundice.[msdmanuals.com]

Treatment

  • Targets underlying heart failure Treatment is directed at the underlying heart failure. Click here for Patient Education NOTE: This is the Professional Version.[msdmanuals.com]

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