Cirrhosis of the liver as a consequence of heart failure

In heart failure, not only the patient's heart suffers, but also other organs, since they are closely related to each other in the process of functioning of the body. With an increase in pressure in the systemic circulation, an overload of the right sections of the heart muscle occurs. As a result, the liver is affected: pain occurs, an increase in size is observed. Congestive liver in heart failure is quite rare, but when such symptoms appear, the patient needs treatment.

Disease pathogenesis

Congestive liver is a pathological condition characterized by stretching of the organ due to stagnation of blood under the influence of high pressure in the veins.

One of the secondary causes of congestive liver conditions is a cardiac symptom. This means that the primary factor in the development of pathology was not a disease of the organ itself, but a dysfunction in the work of the heart. In the later stages, chronic heart failure is observed in cardiac cirrhosis of the liver.

Insufficiency means the inability of the heart to disperse blood through the vessels at the required speed. This leads to its accumulation in the organs, pressure rises, liver edema occurs. Stagnant blood reduces oxygen saturation of tissues, and oxygen starvation occurs. This inevitably leads to necrosis of the liver cells, provoking ischemia. Dead hepatocytes are replaced by fibrous tissue cells, cirrhosis gradually develops.

1. Lung heart.
2. Compressive pericarditis.
3. Mitral valve stenosis.
4. Tricuspid valve insufficiency.
5. Cardiomyopathy.
6. Consequences of the Fontan operation.
7. Severe pulmonary hypertension.

The primary manifestations of a decompensated state of the heart are shortness of breath and arrhythmia during physical exertion. Gradually, shortness of breath occurs at rest, tachycardia accompanies the patient everywhere. With insufficiency of the left ventricle, there is an accumulation of blood in the pulmonary circle.

• wheezing in the lungs;
• sputum interspersed with blood;
• blue tint of lips, fingers.

Cirrhosis of the liver is a manifestation of the disease of the right side of the heart. If the decrease in the efficiency of the right ventricle is not the primary phenomenon, blood stasis accompanies the pathology of the left side of the heart muscle for the second time.

At autopsy, the internal organ is heavy and dense in composition. The color depends on the duration of the stagnation, it varies from red to purple or bluish-brown. Sometimes yellowish spots are observed at the edges of the lobules due to fatty degeneration of the liver cells. In the center of the lobule, the vein cavity has a bluish-red color. Such a liver is called "nutmeg". With a long stagnant process, the pattern of the hepatic lobules is erased. Fibrous tissue formed at the site of dead hepatocytes forms a "false lobularity". With a sudden onset of stagnation, a lot of hemorrhages are recorded.

Clinical picture

Often, in people with heart failure, the manifestation of symptoms of congestive liver is predetermined. This disease inevitably occurs when diagnosing dysfunctions of the heart muscle in the later stages.

Signs of congestion in a weak heart are the same for all types of cirrhosis:

1. Increase in size (At the first stages, the organ grows in front and behind, it is not palpable. With the progression of the pathology of the heart, an increase in the liver is seen, it is determined at the bottom of the right rib. Soreness is due to stretching of the liver capsule).
2. Intense pain under the right rib with a manifestation of heaviness and pressure.
3. Swelling of the limbs.
4. An increase in body temperature.
5. Nausea, vomiting, loss of appetite.
6. Lethargy, weight loss, fatigue.
7. Aggression, bad mood, sleep problems.
8. An increase in the size of the abdomen.
9. Symptoms of jaundice.

These manifestations are a reflection of an abnormal process occurring in the liver itself. The patient in parallel may experience pain associated with impaired functioning of the heart.

The cardiac cause of stagnation is indicated by symptoms that occur with right ventricular failure of the heart: swelling of the arms and legs, shortness of breath at rest or during exertion.

A stagnant internal organ is always an unfavorable phenomenon. Cirrhosis causes activation of the pathological circuit and leads to further complications.

Diagnosis of pathology

At the first visit of the patient to the doctor, a general examination is carried out and the complaints of the sick person are clarified. The disease can be asymptomatic for a long time due to the high compensation of liver cells.

Doctors distinguish cardiac cirrhosis from other types of liver damage by the following symptoms:

1. At the beginning, the enlarged liver has a soft density. Then it hardens and decreases in volume.
2. Treatment of the heart, which is the main cause of congestive processes, leads to an improvement in the patient's condition.
3. When you press the liver, the veins in the neck swell.

1. Blood biochemistry (total protein, enzymes, bilirubin, alkaline phosphatase).
2. Analysis of the structure and volume of the liver using ultrasound.
3. Hemostasiogram (blood clotting test).
4. Chest x-ray (examination of the lungs, determination of the size of the heart).
5. Electrocardiography, echocardiography (analysis of the work of the heart).
6. Laparocentesis (fluid withdrawal from the abdominal cavity).
7. Examination of the coronary vessels of the heart by using angiography.
8. Puncture biopsy of the liver (with transplantation of the heart muscle).

For a correct diagnosis, the presence of hepatitis, inflammation, the presence of toxic elements in the blood (from alcohol, harmful production) and other types of pathology should be excluded.

Treatment of the disease

The only way to prevent congestive cirrhosis is to contact a cardiologist in a timely manner. The success of therapeutic methods depends entirely on the correct recognition of the main disease - disorders of the heart. Doctors are not able to completely cure a sick person, but they are able to achieve an extension of life and alleviate the condition.

The life expectancy of patients suffering from cardiac cirrhosis is 3-7 years. Usually, internal bleeding or the onset of hepatic coma leads to death.

A moderate rhythm of life, a decrease in motor loads and an individually selected course of physical activity are shown. The use of table salt and liquids is limited. It is useful to follow a diet, a balanced diet. Foods that load the liver are strictly prohibited: spices, smoked meats, alcohol, fried and fatty foods.

1. Cardiac glycosides (digoxin) for the treatment and normal functioning of the heart muscle.
2. Beta-blockers (metoprolol) to normalize blood pressure and heart rhythms.
3. Diuretics (amiloride, veroshpiron). The choice and method of using a diuretic depends on the severity of the edematous syndrome, tolerability and the stage of heart disease.
4. Anabolic steroids (nerobolil, retabolil) are prescribed to improve metabolism in the myocardium.

In addition to medicinal drugs, it is recommended to take vitamins (B, C, E) and hepatoprotectors.

Compliance with the instructions of the attending physician helps to alleviate the condition of the person. The patient gets rid of intoxication of the body, edema of the limbs, the general well-being of the patient improves.

Surgery to cut out a congested liver is not used. It is forbidden to give birth to sick women.