Shock liver. Case report with long-term survival

Area of Science:

• Cardiology
• Hepatology
• Nephrology

Background:

• Acute myocardial infarction can lead to cardiogenic shock, a critical condition affecting multiple organ systems.
• Hepatic dysfunction is a recognized, though less common, complication of severe heart failure.
• Portal systemic encephalopathy (PSE) is a neuropsychiatric complication of liver dysfunction.

Observation:

• A patient presented with hepatic failure, including PSE and abnormal liver function tests, secondary to cardiogenic shock post-myocardial infarction.
• The patient also experienced concurrent renal failure necessitating peritoneal dialysis.
• Liver function tests showed significant abnormalities consistent with severe hepatic compromise.

Findings:

• The hepatic failure was reversible, with complete normalization of liver function tests observed.
• The patient achieved long-term survival, documented over nine years post-event.
• Recovery from both hepatic and renal failure was achieved.

Implications:

• This case highlights the potential for reversible liver failure in cardiogenic shock, emphasizing the importance of recognizing and managing this complication.
• It suggests that aggressive management of cardiogenic shock may lead to recovery of hepatic function.
• The findings support the possibility of long-term survival and complete recovery in select patients with myocardial infarction-induced hepatic and renal failure.