Congestive Hepatopathy

(Passive liver congestion)

Congestive hepatopathy is the result of a diffuse venous congestion in the liver, which develops from a right-sided heart failure out (usually due to cardiomyopathy, tricuspid regurgitation, mitral regurgitation, pulmonary hypertension or constrictive pericarditis).

(See also Overview of vascular diseases of the liver.)

Congestive hepatopathy is the result of a diffuse venous congestion in the liver, which develops from a right-sided heart failure out (usually due to cardiomyopathy, tricuspid regurgitation, mitral regurgitation, pulmonary hypertension or constrictive pericarditis). (See also Overview of vascular diseases of the liver.) A moderate or severe right heart failure increases the central venous pressure, which is inferior to the liver via the vena cava and hepatic veins forwarded. The chronic congestion leads to the atrophy of hepatocytes, for the expansion of the sinusoids and a perivenous fibrosis that results in severe cases, to cirrhosis (cardiac cirrhosis). Cause of the death of the liver cells is likely to be a sinusoidal thrombosis, which continues into the central venous and branches of the portal vein and so causes ischemia. Most patients are asymptomatic. However, a moderate liver congestion sometimes causes pain in the right upper quadrant by stretching the liver capsule and a druckdolente hepatomegaly. A pronounced congestion can lead to massive hepatomegaly and jaundice. Ascites may be a result of a transmitted central venous pressure increase; gelegnetlich Also splenomegaly developed. In a transmitted central venous pressure increase a hepatojugulärer reflux is detected in contrast to the congestion as a result of Budd-Chiari syndrome. Diagnosis Clinical assessment The suspected congestive hepatopathy, patients who have a right heart failure, jaundice and a pressure-sensitive hepatomegaly. The laboratory results are generally only slightly outside of the normal range: unconjugated hyperbilirubinemia (total bilirubin <3 mg / dl), <2- to 3-fold increased transaminases and prolonged PT / INR. has ascites fluid, if present, a high albumin content (i d R.> 2.5 g / dl..); In contrast, only 10% of patients with cirrhotic ascites have a level of albumin that level in ascites. Since the laboratory abnormalities are nonspecific, a congestive hepatopathy must be clinically recognized eventually. Liver disease is more of an indicator of the severity of heart failure as a discrete disease. Therapy Aims to the underlying heart failure Treatment depends on the underlying cardiac disease.

Health Life Media Team

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