Cardiac Cirrhosis

Question 1

What is the definition of cardiac cirrhosis?

Answer 1

Prolonged severe right sided congestive heart failure which may lead to chronic liver injury and cardiac cirrhosis

Question 2

What is the aetiology of cardiac cirrhosis?

Answer 2

In right sided heart failure, retrograde transmission of elevated venous pressure via inferior vena cava sand hepatic veins lead to congestion of the liver.
Hepatic sinusoids become dilated and engorged with blood and liver becomes tensely swollen
Necrosis of centrilobular hepatocytes ensues and leads to fibrosis in these central areas

Question 3

What are the clinical features of cardiac cirrhosis?

Answer 3

Liver becomes enlarged and tender, patient may complain of severe right upper quadrant pain

Question 4

What will the lab tests show for cardiac cirrhosis?

Answer 4

Serum bilirubin mildly increased
AST level mildly elevated but may become transiently high following period of marked systemic hypotension
Serum albumin and prothrombin are usually normal

Question 5

What is the diagnosis for cardiac cirrhosis?

Answer 5

Presence of firm, enlarged liver
Liver biopsy can confirm diagnosis but usually contraindicated due to coagulopathy or ascites

Question 6

What is the treatment for cardiac cirrhosis?

Answer 6

Prevention or treatment of cardiac cirrhosis depends on diagnosis and therapy of the underlying cardiovascular disorder
Improvement in cardiac function results in improvement of liver function