Cardiomyopathy unrecognized as a cause of hepatic failure

B. J. Hoffman, M. B. Pate, W. H. Marsh, W. M. Lee

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Two patients with similar symptoms referred for diagnosis and treatment of hepatic failure subsequently proved to have cardiomyopathy as the cause of their hepatic decompensation. Except for fatique and edema, symptoms of congestive heart failure were absent and no history of dyspnea, orthopnea, or paroxysmal nocturnal dyspnea could be elicited. Hepatomegaly was present in both patients, but neck venous distension and hypotension were not apparent, and both patients were able to lie flat. The diagnosis of cardiomyopathy was made by echocardiagram showing global hypokinesis and low ejection fractions; right atrial pressures were markedly increased. Liver biopsies demonstrated centrilobular necrosis and congestion. Treatment for heart failure led to a prompt response in both patients with rapid return of all hepatic parameters toward normal. Paradoxically, our patients had striking evidence of hepatic failure and a notable absence of symptoms and signs of congestive heart failure. An awareness of this unique presentation may avoid prolonged evaluations in such critically ill patients.

Original languageEnglish (US)
Pages (from-to)306-309
Number of pages4
JournalJournal of Clinical Gastroenterology
Volume12
Issue number3
StatePublished - 1990

Fingerprint

Liver Failure
Cardiomyopathies
Heart Failure
Treatment Failure
Liver
Paroxysmal Dyspnea
Atrial Pressure
Hepatomegaly
Critical Illness
Dyspnea
Hypotension
Signs and Symptoms
Edema
Necrosis
Neck
Biopsy

Keywords

  • Cardiomyopathy
  • Heart failure
  • Hepatic failure
  • Ischemic hepatic necrosis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Cardiomyopathy unrecognized as a cause of hepatic failure. / Hoffman, B. J.; Pate, M. B.; Marsh, W. H.; Lee, W. M.

In: Journal of Clinical Gastroenterology, Vol. 12, No. 3, 1990, p. 306-309.

Research output: Contribution to journalArticle

Hoffman, BJ, Pate, MB, Marsh, WH & Lee, WM 1990, 'Cardiomyopathy unrecognized as a cause of hepatic failure', Journal of Clinical Gastroenterology, vol. 12, no. 3, pp. 306-309.
Hoffman, B. J. ; Pate, M. B. ; Marsh, W. H. ; Lee, W. M. / Cardiomyopathy unrecognized as a cause of hepatic failure. In: Journal of Clinical Gastroenterology. 1990 ; Vol. 12, No. 3. pp. 306-309.
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