Presentation
[…] due to long standing congestion. [3] [4] [10] [11] [12] Swelling of the abdomen Cirrhosis is rare but present due to long standing congestion. [3] [4] [10] [11] [12] Features of right heart failure i.e. [explainmedicine.com]
Mediolobular hepatocytes may present fatty change (hypoxic mechanism); periportal hepatocytes are normal. (H&E, ob. x4) Passive congestion (Passive hyperemia) (liver) (detail) Passive congestion of the liver. (H&E, ob. x10) Last updated : 01/30/2009 [pathologyatlas.ro]
With transmitted central venous hypertension, the hepatojugular reflex is present, unlike in hepatic congestion due to Budd-Chiari syndrome . [merckmanuals.com]
Am J Dig Dis 1976; 21:895 [ MEDLINE ] Left-sided heart failure presenting as hepatitis. Gastroenterology 1978; 74:583 Ischemic hepatitis. [mdnxs.com]
Clinical presentation: 1. Due to obstruction to pulmonary vascular out-flow there is pulmonary congestion and edema. 2. [histopathology-india.net]
Liver, Gall & Pancreas
- 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. [merckmanuals.com]
Early retrograde enhancement of dilated inferior vena cava (IVC) and hepatic veins (HVs) Heterogeneous, mottled, reticulated, mosaic hepatic parenchymal pattern Periportal low attenuation (perivascular lymphedema) Hepatomegaly and ascites • US: Loss of [radiologykey.com]
Mild right upper quadrant abdominal pain has been reported to be the result of hepatomegaly and stretching of the hepatic Glisson capsule 1. Asymptomatic elevation of serum liver enzymes may also occur 4. [radiopaedia.org]
We describe a case of nonbacterial thrombotic endocarditis following autologous bone marrow transplantation that was marked by weight gain, hepatomegaly, ascites, and extreme hyperbilirubinemia leading to a clinical diagnosis of hepatic veno-occlusive [ncbi.nlm.nih.gov]
ALP isoenzyme test (Medical Encyclopedia) Ascites (Medical Encyclopedia) Diet - liver disease (Medical Encyclopedia) Hepatic encephalopathy (Medical Encyclopedia) Hepatomegaly (Medical Encyclopedia) Liver disease (Medical Encyclopedia) Liver scan (Medical [icdlist.com]
Skin
- Angiomatosis
Nonalcoholic fatty liver disease (NAFLD) K76.1 Chronic passive congestion of liver Inclusion term(s): Cardiac cirrhosis Cardiac sclerosis K76.2 Central hemorrhagic necrosis of liver K76.3 Infarction of liver K76.4 Peliosis hepatis Inclusion term(s): Hepatic angiomatosis [icd10coded.com]
Workup
In case of unknown cause of ALF, despite a meticulous workup, cardiac failure should always be considered. Right heart catheter evaluation for exact assessment of CI, MPAP, and CVP is mandatory for these patients. [link.springer.com]
Jugular Venous Pressure
- Prominent V-Waves
“v waves” on a right atrial pressure tracing) Clinical : loss of hepatic pulsatility in a patient with long-standing congestive hepatopathy suggests progression to cardiac cirrhosis Hepatojugular Reflux (see Hepatojugular Reflux, Hepatojugular Reflux [mdnxs.com]
Treatment
You can help by adding to it. ( November 2017 ) Treatment [ edit ] Treatment is directed largely to removing the cause, or, where that is impossible, to modifying its effects. [en.wikipedia.org]
Medical treatment must be resorted to in order to relieve passive congestion. In most cases the heart must be strengthened by appropriate tonics. Complete rest is an essential element of treatment. [chestofbooks.com]
Treatment: —Tf these patients be permitted to fast, there will be a natural decrease in the quantity of blood in the liver, without treatment. [henriettes-herb.com]
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Treatment of Underlying Congestive Heart Failure (see Congestive Heart Failure, Congestive Heart Failure ): aim to optimize cardiac output Diuretics: may significantly improve jaundice and ascites However, over-diuresis may precipitate hepatic necrosis [mdnxs.com]
Prognosis
Unlike cirrhosis caused by chronic alcohol use or viral hepatitis, the effect of cardiac cirrhosis on overall prognosis has not been clearly established. [emedicine.medscape.com]
Analysis of the contributing factors and its relation to the early prognosis. J Thorac Cardiovasc Surg 1988;96:219-26. Camposilvan S, Milanesi O, Stellin G, Pettenazzo A, Zancan L, D'Antiga L. [acc.org]
A limitation of this study is the lack of disease-free survival analysis, an element that limits the utility of the congestive hepatic fibrosis score for prognosis. [nature.com]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
Physiology Liver has Complex Vascular Supply and High Metabolic Rate : makes it vulnerable to circulatory dysfunction from a variety of etiologies Congestive Hepatopathy : passive hepatic congestion, usually attributable to right-sided congestive heart [mdnxs.com]
Physical examination of patients with cirrhosis may reveal a variety of findings that necessitate a hepatic- or gastrointestinal-based work-up to determine the etiology. [aafp.org]
[…] recognize cardiac source of liver disease • Diagnosis is based on clinical and imaging findings DIAGNOSTIC CHECKLIST • Differentiate acute passive hepatic congestion from Budd-Chiari and viral hepatitis • Distinguish chronic, cardiac cirrhosis from other etiologies [clinicalgate.com]
Epidemiology
[…] causes hepatic encephalopathy Hepatic Pulsatility Epidemiology : may be seen in cases associated with tricuspid regurgitation (presystolic pulsations corresponding to prominent “v waves” on a right atrial pressure tracing) Clinical : loss of hepatic [mdnxs.com]
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]
Moreover we were not able to make any conclusions about the epidemiology of ALF caused by cardiac failure. [link.springer.com]
Relation of hemochromatosis with hepatocellular carcinoma: epidemiology, natural history, pathophysiology, screening, treatment, and prevention. Med Clin North Am. 2005;89:391–409. 19. Neimark E, Schilsky ML, Shneider BL. [aafp.org]
Pathophysiology
We discuss the pathophysiology and clinical features of nonbacterial thrombotic endocarditis and review its occurrence in association with bone marrow transplantation. [ncbi.nlm.nih.gov]
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]
Pathophysiology Decompensated right ventricular or biventricular heart failure causes transmission of elevated right atrial pressure to the liver via the inferior vena cava and hepatic veins. [emedicine.medscape.com]
Fulminant hepatic failure caused by congestive heart failure has rarely been documented; furthermore the exact pathophysiology remains unclear. [link.springer.com]
When severe and longstanding, hepatic congestion can lead to cirrhosis, a state described as cardiac cirrhosis. [1] Pathophysiology Increased pressure in the sublobular branches of the hepatic veins causes an engorgement of venous blood, and is most frequently [wikidoc.org]
Prevention
/Avoidable - 0% Emergent - ED Care Needed - Not Preventable/Avoidable - 0% Primary diagnosis of injury 0% Primary diagnosis of mental health problems 0% Primary diagnosis of substance abuse 0% Primary diagnosis of Alcohol 0% Unclassified 100% Health Topic [codelay.com]
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Centers for Disease Control and Prevention. Alcohol-attributable deaths and years of potential life lost—United States, 2001. MMWR Morb Mortal Wkly Rep. 2004;53:866–70. 8. [aafp.org]
However, even with these drugs, indirect effects should be considered to prevent, for instance, intravascular depletion with diuretics, which may exacerbate reduced blood flow in an already compromised liver. [gastroenterologyandhepatology.net]