[Severe ischemic hepatitis after taking cibenzoline]

The authors report the case of a 77 year old man suffering from chronic congestive heart failure, who presented a severe hepatic failure. Since 9 days the patient was treated by cibenzoline for serious ventricular arythmias. Hepatic failure was not due to drug hepatotoxicity but to an indirect effect of cibenzoline diminishing cardiac output. Arguments for ischaemic hepatitis and also two mechanisms of hepatic involvement in cardiac diseases are developed. In most cases association of two mechanisms, vascular stasis and low cardiac output is necessary to create hypoxic hepatitis.