These defects when undiagnosed during childhood, present in adulthood with symptoms of right heart failure. We describe a case of uncorrected ostium primum atrial septal defect that presented as liver failure in a 43-year-old woman. [journals.lww.com]

When symptoms are present, these are gradual but may present abruptly in acute right ventricular decompensation, constrictive pericarditis, or acute decompensation of valve disease. Jugular venous distention is also present. [ncbi.nlm.nih.gov]

Our patient had a classical presentation with CCP ten years ago. He received timely surgery, and was asymptomatic for ten years before presenting with cirrhosis. Long-term survival after pericardiectomy depends on the underlying cause. [omicsonline.org]

• Congestive Heart Failure

  Disease caused by congestive heart failure, the right atrium and right ventricular pressure increased, affecting the hepatic venous blood reflux caused by liver congestion, cirrhosis. [healthfrom.com]

  heart failure; true cirrhosis with fibrous bridging of lobules is unusual. cardiac cirrhosis Etymology: Gk, kardia, heart, kirrhos, yellow-orange, osis, condition an increase of fibrous tissue in the liver resulting from congestive heart failure, chronic [medical-dictionary.thefreedictionary.com]

  'Cardiac cirrhosis' is the cirrhosis resulting from prolonged passive liver venous congestion secondary to right-sided congestive heart failure; hepatocellular carcinoma is a rarely reported outcome. [ncbi.nlm.nih.gov]

  Background Cardiac cirrhosis (congestive hepatopathy) includes a spectrum of hepatic derangements that occur in the setting of right-sided heart failure. Clinically, the signs and symptoms of congestive heart failure (CHF) dominate the disorder. [emedicine.medscape.com]

• Inflammation

  Repetitive inflammation as a result causes cirrhosis. [mymed.com]

  ( J Hepatol 2015;63:1038 ) Cirrhosis is potentially reversible after successful treatment of chronic liver disease, e.g. viral hepatitis Cessation of chronic damage allows hepatocyte recovery and modulates the microenvironment Shifting balance from inflammation [pathologyoutlines.com]

  The term is sometimes used to refer to chronic interstitial inflammation of any organ. cardiac cirrhosis fibrosis or scarring of the liver resulting from the anoxia and centrilobular necrosis associated with the passive congestion of congestive heart [medical-dictionary.thefreedictionary.com]

  Hepatitis: Hepatitis means inflammation of the liver from any cause, but it usually refers to a viral infection of the liver. Over many years the inflammation damages liver cells and leads to scarring. [emedicinehealth.com]

  A heart attack (myocardial infarction) is a result of a blockage or inflammation of the arteries. Congestive heart failure is the decreased ability of the heart to pump blood forward in a cyclical manner. [wisegeek.com]

• Weight Gain

  […] from blood vessels to lymphatic space, the lympathic system leaks through the liver capsule into the peritoneal cavity and the osmotic pressure pulls even more fluid into the peritoneal cavity weight gain, abdominal distention, striae, inverted umbillicus [quizlet.com]

  […] loss and exercise Cessation of smoking and alcohol consumption Immunization : pneumococcal vaccine and seasonal influenza vaccine Patient education Self-monitoring and symptom recognition Daily weight check Weight gain > 2 kg within 3 days : consult [amboss.com]

  Fever Vomiting Diarrhea Itching - From deposition in the skin of products of the breakdown of bile Abdominal pain - From enlargement of the liver or formation of gallstones Abdominal swelling or bloating - From fluid retention Weight gain - From fluid [emedicinehealth.com]

  D: These clients typically have ascites and edema so experience weight gain. 4. A client diagnosed with chronic cirrhosis who has ascites and pitting peripheral edema also has hepatic encephalopathy. [nurseslabs.com]

• Non-Alcoholic Cirrhosis

  Juvenile portal cirrhosis Laennec's cirrhosis, non-alcoholic Latent cirrhosis Liver cirrhosis Macronodular cirrhosis Micronodular cirrhosis Mixed micro AND macronodular cirrhosis Multilobular portal cirrhosis Nonalcoholic cirrhosis Nutritional cirrhosis [icd9data.com]

  […] abnormalities may coincide with limitation of liver function. 26 Clinical consequences attributable to liver disease such as ascites and hepatic encephalopathy are not rare in the Fontan population and single ventricle physiology is associated with non-alcoholic [acc.org]

• Atrial Septal Defect

  Further examination revealed an atrial primum septal defect. Liver cirrhosis in this patient was thought to be secondary to chronic congestion from the right heart failure resulting from the atrial septal defect. [journals.lww.com]

  The patient had undergone cardiac surgery for pulmonary valve insufficiency, pulmonary stenosis and atrial septal defect when she was fifteen years of age. [pubfacts.com]

• Easy Bruising

  When symptoms do appear, they include, bleeding or easy bruising, swelling, fatigue, and a yellow coloring to the skin and whites of the eyes. [emedicinehealth.com]

  Easy bruising. Poor concentration and memory. Bleeding oesophageal varices. Spontaneous bacterial peritonitis. Signs [ 3 ] Physical signs are variable and depend upon the extent of disease. Cutaneous features of cirrhosis include: Jaundice. [patient.info]

• Nausea

  Chronic hepatitis: fatigue, discomfort, loss of appetite, nausea and abdominal pain (right hypochondrium). Associated with thyroid disorders. Additional tests The diagnosis is clinical, and is based on patient consultation and physical examination. [mediktor.com]

  […] gamma globulins and dysfunction of phagocytic Kupffer cells; impaired gas exchange related to pressure against the lungs by ascitic fluid; potential for injury related to altered levels of consciousness; alteration in nutrition related to indigestion, nausea [medical-dictionary.thefreedictionary.com]

  Symptoms and signs of liver cirrhosis include the following: Nausea, vomiting, diarrhea, loss of appetite, fatigue Pain in right upper abdomen Fever Jaundice with yellowing of the skin and the eyes Itching Reddening of the palms and spider web-like reddening [medindia.net]

  Symptomatic patients due to liver dysfunction typically present with abdominal pain that can be localized in the right upper quadrant (secondary to hepatic capsule dilation), nausea and vomiting, jaundice, hepatomegaly, abdominal distention, and ascites [ncbi.nlm.nih.gov]

  Early indicators usually involve gastrointestinal signs and symptoms such as anorexia, indigestion, nausea, vomiting constipation, or diarrhea. Respiratory system. [nurseslabs.com]

• Vomiting

  You might have fever, abdominal swelling or pain, difficulty breathing, vomiting, diarrhea, bleeding from gums or nose, blood in your vomit or feces, and abnormal menstrual periods. [natap.org]

  Gastrointestinal catarrh is usually present, and vomiting of blood may occur. There is usually more or less jaundice. Owing to portal obstruction, ascites occurs, followed later by generalised oedema. [en.wikipedia.org]

  The blood vessels can rupture resulting in vomiting of blood and black tarry stools. Ascites : The increased portal pressure also causes fluid accumulation in the abdomen (ascites) and in subcutaneous tissues (edema). [medindia.net]

  Vomiting of blood - Vomiting of blood can be related to liver disease in several ways. One of the more ominous is esophageal varices. Esophageal varices are essentially varicose veins in the esophagus. [verywell.com]

• Loss of Appetite

  Chronic hepatitis: fatigue, discomfort, loss of appetite, nausea and abdominal pain (right hypochondrium). Associated with thyroid disorders. Additional tests The diagnosis is clinical, and is based on patient consultation and physical examination. [mediktor.com]

  Symptoms and signs of liver cirrhosis include the following: Nausea, vomiting, diarrhea, loss of appetite, fatigue Pain in right upper abdomen Fever Jaundice with yellowing of the skin and the eyes Itching Reddening of the palms and spider web-like reddening [medindia.net]

  […] of appetite leading to weight loss Loss of sex drive Symptoms may not appear until complications of cirrhosis set in. [emedicinehealth.com]

• Heart Failure

  Congestive heart failure is the decreased ability of the heart to pump blood forward in a cyclical manner. Heart failure can be brought on by a heart attack, uncontrolled blood pressure or heart valve disease. [wisegeek.com]

  failure, available diuretics, cardiac drugs and reduce the heart after the load of drugs. [healthfrom.com]

  'Cardiac cirrhosis' is the cirrhosis resulting from prolonged passive liver venous congestion secondary to right-sided congestive heart failure; hepatocellular carcinoma is a rarely reported outcome. [ncbi.nlm.nih.gov]

  Prognosis Prognosis depends on the severity of the underlying heart disease and the degree of heart failure. [emedicine.medscape.com]

  GGT – an established prognostic marker of heart failure- is drastically increased in the cirrhotic group. [thieme-connect.com]

• Hypertension

  Signs of pulmonary hypertension include a closely split S 2 with a loud pulmonic component. [emedicine.medscape.com]

  Prevention Cardiogenic cirrhosis prevention Mainly to prevent myocarditis, prevention and treatment of hypertension and other cardiovascular diseases. [healthfrom.com]

  Table 302-2 Complications of Cirrhosis Portal hypertension Coagulopathy Gastroesophageal varices Factor deficiency Portal hypertensive gastropathy Fibrinolysis Splenomegaly, hypersplenism Thrombocytopenia Ascites Bone disease Spontaneous bacterial peritonitis [slideshare.net]

  Method: In a monocentric study of case series patients with either pulmonary arterial hypertension (PAH) or pulmonary hypertension due to left heart disease (PH-LH) were systematically investigated. [erj.ersjournals.com]

  There is a reflex increase in arterial flow that contributes to the portal hypertension. It is becoming known that cirrhosis is to some degree reversible. [link.springer.com]

• Hepatojugular Reflux

  Further distention of neck veins may be elicited with application of pressure over the right upper quadrant for as long as 1 minute (ie, hepatojugular reflux). [emedicine.medscape.com]

  Heart failure (heart cirrhosis): oedema, dyspnoea, fatigue, anorexia, dilated jugulars (jugular ingurgitation), coughing, hepatojugular reflux, heart murmurs and an enlarged liver. [mediktor.com]

  Hepatojugular reflux is usually present and can help in differentiating hepatic congestion from Budd-Chiari syndrome. A pulsatile liver can be seen with severe tricuspid regurgitation or pericardial disease-causing congestive hepatopathy. [ncbi.nlm.nih.gov]

• Distention of Neck Veins

  Further distention of neck veins may be elicited with application of pressure over the right upper quadrant for as long as 1 minute (ie, hepatojugular reflux). [emedicine.medscape.com]

• Hepatomegaly

  Hepatomegaly Hepatomegaly is common, usually presenting as a firm, hard liver. Elevated hydrostatic pressure within the hepatic veins and the peritoneal venous drainage system causes cardiac ascites. [emedicine.medscape.com]

  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. [merckmanuals.com]

  Previous research has demonstrated that patients with cardiac cirrhosis present with symptoms of liver congestion – hepatomegaly, splenomegaly, esophageal varices and ascites. [gastrohep.com]

  Hepatomegaly is very commonly seen with a purple hue. [ncbi.nlm.nih.gov]

• Liver Dysfunction

  Liver dysfunction can become a serious medical issue, as an impaired liver is less capable of metabolizing chemical compounds. [wisegeek.com]

  Complications The complications of cardiac cirrhosis depend on the complications of the underlying cardiac abnormality and liver dysfunction. [ncbi.nlm.nih.gov]

  Drug-induced hepatitis - There are many drugs which can cause liver dysfunction. [verywell.com]

  Congestive hepatopathy, also known as nutmeg liver and chronic passive congestion of the liver, is liver dysfunction due to venous congestion, usually due to congestive heart failure. [en.wikipedia.org]

  Arrhythmia, liver dysfunction, and coagulation disorders. J Thorac Cardiovasc Surg 1993;106:1126-32. Nevens F, Lijnen P, VanBilloen H, Fevery J. [acc.org]

• Liver Palms

  Liver palm, spider nevus and "sea snake head" rare. [healthfrom.com]

The diagnosis of CHF is based on clinical presentation and requires an initial workup to assess disease severity and possible causes. The initial workup includes measurement of brain natriuretic peptide levels, chest x-ray, and ECG. [amboss.com]

• Hypoalbuminemia

  Liver biopsy may be indicated in patients with cardiac ascites and hypoalbuminemia before transplantation [25]. [ejcts.oxfordjournals.org]

  Hypoalbuminemia is rarely less than 2.5 g/dL. This factor is an independent predictor of death in patients with acute on chronic heart failure. The degree of reduction in serum albumin does not correlate with the degree of liver damage. [ncbi.nlm.nih.gov]

  The liver function tests were abnormal with mildly elevated liver enzymes, bilirubin of 3.4 mg/dl and hypoalbuminemia. INR was 1.79.USG abdomen showed a shrunken liver with gross ascites without any pericardial effusion. [omicsonline.org]

• Hypoglycemia

  Continued fluid and electrolyte imbalances and inefficient metabolism of nutrients produce ascites, hypoglycemia, and hypoproteinemia. [medical-dictionary.thefreedictionary.com]

  However, some of these patients are caused by the liver, such as intractable hypoglycemia and disturbance of consciousness, which is also associated with reduced cardiac output. 2, cardiogenic cirrhosis itself does not cause severe portal hypertension [healthfrom.com]

• Enlargement of the Spleen

  […] and firm, often associated with slight enlargement of the spleen Modest elevations of ALT, AST, LDH, r-GT,ALP, T-Bil small decreases in albumin levels Liver function abnormalities are most commonly seen in patients with a cardiac index lt 1.5 L/min per [powershow.com]

• Liver Biopsy

  […] phosphatase no significant change. with the improvement of congestive heart failure, liver function test improved rapidly, liver biopsy biopsy help to confirm the diagnosis. [healthfrom.com]

  Background And Aims : A method for assessment of liver fibrosis and cirrhosis without the need for a liver biopsy is desirable. [pubfacts.com]

  Fig. 2 A liver biopsy histopathology slide demonstrating classical features of cardiac cirrhosis. [gastrohep.com]

  Liver biopsy showed cirrhosis. After extensive evaluation, a diagnosis of cardiac cirrhosis was made. [omicsonline.org]

  Liver biopsy remains a pivotal role in evaluation of the grade of inflammation and stage of cirrhosis before transplantation. Liver biopsy may be indicated in patients with cardiac ascites and hypoalbuminemia before transplantation [25]. [ejcts.oxfordjournals.org]

Keeffe, gives you quick reference to the most recent diagnostic and treatment options for patients with liver disorders. [books.google.com]

Treatment Treatment of cardiogenic cirrhosis Department of Gastroenterology Surgery Internal Medicine Treatment: drug treatment supportive treatment Treatment cycle: 3 months Cure rate: 30% Commonly used drugs: twenty - five flavored turquoise tablets [healthfrom.com]

Treatments can include medications and surgery, depending on the underlying cause of the heart failure and the patient's general level of health. If early damage to the liver has occurred, treatment should prevent increases in severity. [wisegeek.com]

[…] edema with diuretics Esophageal varices and splenomegaly may also be present Portal flow studies Liver biopsy 15 Congestive liver fibrosis (CLF) and Congestive cirrhosis (cardiac cirrhosis CC) Treatment no prospective studies Similar to heart failure [powershow.com]

Medical Care No prospective studies have been performed to evaluate the medical treatment of cardiac cirrhosis. [emedicine.medscape.com]

No evidence that CC worsens the prognosis of patents with CHF The mortality rate is determined by the severity of the underlying cardiac disease 16 Hepatic acinus Zone 1 periportal region Zone 2 Zone 3 perivenular region [powershow.com]

[…] depends on the prognosis of the underlying cardiac abnormality. [ncbi.nlm.nih.gov]

Offer your liver transplantation patients the best prognosis and follow-up with the latest information on outcomes and the management of complications. [books.google.com]

Prognosis Prognosis depends on the severity of the underlying heart disease and the degree of heart failure. [emedicine.medscape.com]

Treatment and prognosis Cardiac cirrhosis may be irreversible even after treatment of the underlying cardiac failure 2. Promoted articles (advertising) [radiopaedia.org]

Hepatocellular carcinoma has been commonly associated with multiple etiologic factors including hepatitis B and C, alcoholic liver disease, and more rarely congenital metabolic liver diseases. [ncbi.nlm.nih.gov]

The worst post-surgical prognosis occurs in postradiation constrictive pericarditis (27% survival at 7 years), probably due to an associated neoplastic etiology [ 9, 10 ]. [omicsonline.org]

Etiology Causes of cardiac cirrhosis include 1 : ischemic heart disease: ~30% cardiomyopathy: ~25% valvular heart disease: ~25% restrictive lung disease: ~15% pericardial disease: ~10% Pathophysiology Fibrosis bridging between central zonal regions can [radiopaedia.org]

Approximately 1 year after ablation, he was diagnosed with cirrhosis of congestive etiology (cardiac cirrhosis) and is currently listed for combined heart-liver transplantation. Conclusion. [atcmeetingabstracts.com]

Epidemiologic characters, serum laboratory values, and fluid characteristics were directly compared between the groups. [ncbi.nlm.nih.gov]

Epidemiology Frequency United States Cardiac cirrhosis rarely occurs in the United States. Its true prevalence is difficult to estimate, since the disease typically remains subclinical and undiagnosed. [emedicine.medscape.com]

References: [2] [3] Epidemiological data refers to the US, unless otherwise specified. Etiology The three major causes of heart failure are coronary artery disease, hypertension, and diabetes mellitus. [amboss.com]

Abstracts Objectives: Cardiogenic ascites has been well described regarding its pathophysiology and fluid characteristics in prior literatures. [ncbi.nlm.nih.gov]

Etiology Causes of cardiac cirrhosis include 1 : ischemic heart disease: ~30% cardiomyopathy: ~25% valvular heart disease: ~25% restrictive lung disease: ~15% pericardial disease: ~10% Pathophysiology Fibrosis bridging between central zonal regions can [radiopaedia.org]

Despite a developed pathophysiological link between cardiac cirrhosis and the Fontan procedure, there are very few reports describing the occurrence of HCC in post-Fontan patients. [atcmeetingabstracts.com]

Although inferior vena caval thrombosis and Budd-Chiari syndrome exhibit similar pathophysiology, they are categorized separately and are not included as causes of cardiac cirrhosis. [emedicine.medscape.com]

Pathophysiology [ edit ] CT appearance of liver in congestive hepatopathy, sometimes referred to as a nutmeg liver. Due to congestion, contrast does not flow through the liver in a normal manner. Axial and coronal images in the portal venous phase. [en.wikipedia.org]

[…] committed to preventing and curing liver disease. [aasld.org]

Prevention Cardiogenic cirrhosis prevention Mainly to prevent myocarditis, prevention and treatment of hypertension and other cardiovascular diseases. [healthfrom.com]

How can you Prevent Cirrhosis? Cirrhosis can be prevented taking the following steps: Keep your alcohol consumption under control. [medindia.net]

B: Careful repositioning can prevent skin breakdown. A: Range of motion exercises preserve joint function but do not prevent skin breakdown. [nurseslabs.com]

If early damage to the liver has occurred, treatment should prevent increases in severity. [wisegeek.com]