Presentation
With transmitted central venous hypertension, the hepatojugular reflex is present, unlike in hepatic congestion due to Budd-Chiari syndrome. [msdmanuals.com]
Entire Body System
- 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]
Immune System
- 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]
Gastrointestinal
- Regurgitation
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, or constrictive pericarditis). [msdmanuals.com]
Cardiovascular
- Heart Failure
Severe heart failure causes blood to back up from the heart into the inferior vena cava (the large vein that carries blood from the lower parts of the body to the heart). [merckmanuals.com]
Liver, Gall & Pancreas
- Jaundice
Clinical evaluation 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]
Psychiatrical
- Suggestibility
In addition, a high ascitic total protein content (typically > 2.5 g/dL [25 g/L]) plus a SAAG ≥ 1.1 g/dL (11 g/L) suggests congestive hepatopathy (2) and differentiates portal hypertension from cirrhosis. [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]