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Morphological Cardiac Alterations in Liver Cirrhosis: An Autopsy Study
Banushree Chandrasekhar Srinivasamurthy1, Sanjay P Saravanan1, Fremingston K Marak2
1Department of Pathology, Indira Gandhi Medical College and Research Institute, Puducherry, India.
Insights
Liver cirrhosis frequently causes cardiac changes like cardiomegaly and hypertrophy. Understanding these heart alterations is crucial for managing patients and improving their quality of life.
Area of Science:
- Cardiology
- Hepatology
- Pathology
Background:
- Liver cirrhosis is associated with significant cardiac complications impacting patient prognosis.
- Cardiac alterations in cirrhosis patients without prior heart disease are understudied.
- Early identification of cardiac changes can enhance patient quality of life.
Purpose of the Study:
- To investigate anatomical and morphological cardiac variations in liver cirrhosis patients.
- To document macroscopic and microscopic cardiac changes in cirrhosis.
Main Methods:
- A prospective, autopsy-based, cross-sectional study included forty consecutive cirrhosis patients.
- Exclusion criteria: known history of cardiac disease or anomaly.
- Macroscopic and microscopic examination of hearts and coronaries, with statistical analysis.
Main Results:
- Cardiomegaly observed in 77.5% of cases; 100% showed left ventricular hypertrophy.
- Endocardial thickening (55%) and mitral valve calcification (22.5%) were noted.
- Microscopic findings included interstitial edema (47.5%), fibrosis (45%), muscle disarray (87.5%), and coronary atherosclerosis (17.5%).
Conclusions:
- Cardiac involvement in liver cirrhosis is common and requires clinical attention.
- Awareness of these cardiac changes is vital for physicians and surgeons, especially for liver transplantation.
- Understanding cardiac alterations aids in preventing adverse outcomes and improving patient quality of life.
Background:
Cirrhosis can cause various cardiac complications and severely affect the prognosis of the patient suffering from cirrhosis. Anatomical, morphological variations in the heart of patients with liver cirrhosis in the absence of known cardiac disease has not been well described. There is a paucity of studies in the literature on cardiac alterations in cirrhosis. Early detection of known cardiac alterations can further help in improving the quality of life.
Materials And Methods:
A cross-sectional descriptive study was conducted in the departments of pathology and forensic medicine of our institution. An autopsy-based prospective study of forty consecutive patients with final diagnosis of liver cirrhosis were included. Patients with a known history of cardiac disease/anomaly were excluded from the study. Macroscopic and microscopic changes in the heart and coronaries were noted and statistically analyzed.
Results:
Analysis of the hearts on gross examination showed cardiomegaly in 31 patients (77.5%). All cases had left ventricular hypertrophy. Endocardial thickening was seen in 22 patients (55%). Calcified mitral valve was seen in 9 patients (22.5%).On microscopy, apart from hypertrophy, the pathological changes like interstitial oedema (47.5%), fibrosis (45%), cardiac muscle disarray (87.5%), fatty infiltrate (10%), pericarditis (5%), and severe coronary artery atherosclerosis (17.5%) were seen in the patients.
Conclusion:
Knowledge about the involvement of the heart in liver cirrhosis is essential for both the physician and the surgeons to prevent adverse outcomes during liver transplantation and can further help in improving the quality of life of the patient.
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