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"Acute liver failure": the heart may be the matter
K de Leeuw1, J H J M Meertens, I C C van der Horst
1Department of Internal Medicine, Division of Rheumatology and Clinical Immunology, University Medical Centre Groningen, the Netherlands. k.de.leeuw@int.umcg.nl
Acta Clinica Belgica
|August 16, 2011
Summary
Hypoxic hepatitis, a liver issue from heart failure, can be hard to diagnose. Echocardiography is key to identifying this treatable condition, even with vague symptoms.
Area of Science:
- Cardiology
- Hepatology
- Critical Care Medicine
Background:
- Hypoxic hepatitis is a recognized cause of liver failure, often linked to heart failure.
- Diagnosing hypoxic hepatitis can be challenging, particularly when cardiac symptoms are not apparent.
Observation:
- Two patients presented with acute liver failure, elevated aminotransferases, lactic acidosis, and coagulation issues.
- Non-specific clinical symptoms and absent overt heart failure signs complicated the initial diagnosis.
- Echocardiography revealed underlying right ventricular dysfunction in both cases.
Findings:
- Prompt treatment with inotropes led to rapid normalization of liver enzymes, acidosis, and coagulation parameters.
- These clinical improvements confirmed hypoxic hepatitis as the cause of acute liver dysfunction.
- Echocardiography proved crucial in identifying the cardiac origin of the liver problem.
Implications:
- Clinicians should consider hypoxic hepatitis in cases of unexplained acute liver dysfunction.
- Echocardiography is recommended for diagnosing hypoxic hepatitis, even with non-specific cardiac symptoms.
- Early diagnosis and treatment of hypoxic hepatitis secondary to heart failure can prevent progression to liver failure.
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