Cardiac Cirrhosis–An Uncommon Manifestation of Common Disease

Abstract

Background: Chronic Right Heart failure is known to cause Liver Cirrhosis but it is rare. Here we are reporting the case of cardiac cirrhosis presented to us with signs of Liver Failure. Case Report : 50 year male, farmer, chronic smoker presented with progressive abdominal distension and episodes of malena since 6 months and an episode of hematemasis. On work up Liver cirrhosis was diagnosed but cause for cirrhosis was not established and on general examination pulse was irregular and features of pulmonary hypertension were present. On reviewing he revealed history of chronic cough and breathlessness with winter exacerbations and pedal edema. Chest X-ray suggested cardiomegaly, ECG suggested low voltage complex with poor R wave progression and 2-D Echo suggested pulmonary hypertension with tricuspid regurgitation with right sided dysfunction suggesting cardiac cause for cirrhosis. Conclusion : Chronic Right Heart Failure is known but rare cause of Liver cirrhosis.

Hyperthyroidism with Biventricular Heart Failure and Cirrhotic Transformation of the Liver

“…In contrast to primary PH that carries a poor prognosis and has limited treatment options, PH due to Graves' disease carries a good prognosis, with prior reports of resolution after appropriate treatment [3, 6, 11, 14], emphasizing the importance of early recognition. Also, it is very rare for hyperthyroidism-driven heart failure to lead to cirrhosis, and cirrhosis has been reported mostly in chronic right heart failure [18]. Unlike cirrhosis caused by alcohol or viral hepatitis, the effect of cardiac cirrhosis on overall prognosis has not been clearly established [18, 19].…”

“…Also, it is very rare for hyperthyroidism-driven heart failure to lead to cirrhosis, and cirrhosis has been reported mostly in chronic right heart failure [18]. Unlike cirrhosis caused by alcohol or viral hepatitis, the effect of cardiac cirrhosis on overall prognosis has not been clearly established [18, 19]. By this case, we want to highlight the importance of considering hyperthyroidism early on in the differential for unexplained valvular regurgitation and heart failure and also considering cardiac cause as a differential for liver cirrhosis.…”

Autonomic regulation of imbalance‑induced myocardial fibrosis and its mechanism in rats with cirrhosis

“…In 1953, Kowalski and Abelmann first documented abnormal cardiac functions in patients with liver cirrhosis (3). Since then, a series of animal models and clinical studies have confirmed further that myocardial contractility and stimulation in patients with cirrhosis are weakened, where in severe cases heart failure can occur (4)(5)(6). This condition is known as cirrhotic cardiomyopathy (CCM) (4)(5)(6).…”

“…Since then, a series of animal models and clinical studies have confirmed further that myocardial contractility and stimulation in patients with cirrhosis are weakened, where in severe cases heart failure can occur (4)(5)(6). This condition is known as cirrhotic cardiomyopathy (CCM) (4)(5)(6). Previous studies have shown that echocardiography (ECG) can be used to evaluate left ventricular diastolic functions in patients with cirrhosis (7,8).…”