Clinical Investigations: Acute Ischemic Heart DiseaseHeart diseases affecting the liver and liver diseases affecting the heart☆
Section snippets
Heart diseases affecting the liver
Hepatic complications of heart failure comprise a spectrum of combined cardiac and hepatic disorders (Table I).Heart diseases affecting the liver Mild alterations of liver function tests in heart failure Cardiogenic IH and its variants CLF and congestive (cardiac) cirrhosis Liver diseases affecting the heart HPS in liver cirrhosis PPHTN in liver cirrhosis Pericardial effusion in cirrhosis Cirrhotic cardiomyopathy High-output failure caused by intrahepatic
Liver diseases affecting the heart
The resting cardiac output, left ventricular diastolic diameter, and mean velocity of left ventricular wall contraction may all be increased in patients with liver cirrhosis and are reversible after liver transplantation.1, 22 The hemodynamic consequences of liver disease, in the systemic and pulmonary circulation, hereafter called liver diseases affecting the heart, include: hepatopulmonary syndrome in cirrhosis, plexogenic pulmonary hypertension in cirrhosis, pericardial effusion in
Joint causes of hepatic and cardiac disorders
The heart and liver can both be targets of a common pathogenic process, which may be infectious, metabolic, immune, vasculitic, or toxic. Detailed inventory of these disorders is beyond the aim of this paper. Clues to their distinction from heart diseases affecting the liver and liver diseases affecting the heart may be found in the patient history and clinical examination. First, the simultaneous onset of a cardiac and liver disease during the course of an acute disorder may hint to a common
Diagnostic approach
The approach to the diagnosis of combined cardiac and hepatic disorders is based on recognizing the sequence of appearance of the cardiac and liver disease, presence of features of a multisystem disease, and presence of pathognomonic features. Consideration is given to the expected benefit of treatment and the risks related to invasive procedures in patients with advanced cardiac and liver disease. In most instances investigations can be limited to ancillary tests, as exemplified by mild
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Reprint requests: Jochanan E. Naschitz, MD, Department of Internal Medicine A, Bnai Zion Medical Center, PO Box 4940, 31048 Haifa, Israel.