At the heart of the problem: congestive cardiac failure as a cause of ascites: A narrative review

Abstract

Heart failure leading to cardiac ascites is an extremely rare and underrecognized entity in clinical practice. Recognizing cardiac ascites can be difficult, especially since patients presenting with ascites may have more than 1 etiology. Various biomarkers are available to aid in the diagnosis of cardiac ascites, though with differing sensitivities and specificities. Such biomarkers include serum albumin, ascitic albumin and protein, as well as serum N-terminal pro-brain natriuretic peptide (NT-proBNP). While serum NT-proBNP is a powerful biomarker in distinguishing the etiology of ascites and monitoring treatment progression, its cost can be prohibitive in low-resource settings. Clinicians practicing under these circumstances may opt to rely on other parameters to manage their patients. We go on further to report a series of 3 patients with cardiac ascites to illustrate how these biomarkers may be employed in the management of this patient population. Clinicians should always keep in mind the differential diagnosis of cardiac failure as a cause of ascites. The resolution of cardiac ascites may serve as a surrogate clinical marker for response to antifailure therapy in lieu of NT-proBNP at resource-scarce centers.

Dilated cardiomyopathy phenotype in Callithrix penicillata (E. Geoffroy, 1812): Case report

“…Cardiac auscultation demonstrated murmur and gallop rhythm, which may indicate heart failure and is compatible with the clinical suspicion of DCM 12 . In addition to the change in auscultation, the animal presented ascites, which although it can have more than one cause, including cirrhosis hepatic, heart failure can be a triggering factor for the change 13 …”

“…12 In addition to the change in auscultation, the animal presented ascites, which although it can have more than one cause, including cirrhosis hepatic, heart failure can be a triggering factor for the change. 13 A species of NHP was reported with the disease of systolic dysfunction diagnosed by echocardiographic examinations. Also, a specimen of Ateles chamek in the peripartum period 14 and Pan troglodytes.…”

Right congestive heart failure in domestic kitten (Felis domesticus) by dilation of the pulmonary veins and cardiomegali

“…Ascites represent a clinical symptom manifestation of heart failure ( Goh et al , 2022 ; Damara et al , 2023 ). The physical examination of the heart organ through auscultation revealed findings of a murmur (sound).…”

Spontaneous Bacterial Peritonitis: A Rare Complication of Pulmonary Arterial Hypertension

“…Sinusoidal congestion leads to a protein-rich exudate that is initially drained by the liver's lymphatic system. Once the volume of exudate overwhelms the lymphatic system, it collects in the peritoneal cavity, resulting in ascites [2].…”