Cirrhotic Cardiomyopathy - Diagnosis and Management ...
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Cirrhotic Cardiomyopathy - Diagnosis and Management Summary

 • Definition: chronic cardiac dysfunction in cirrhotic patients with no known cardiac disease; characterized by 1) impaired cardiac contractility in response to stress, 2) altered diastolic relaxation, 3) electrophysiological abnormalities such as prolonged QTc

 • Prevalence: up to 50% of patients undergoing liver transplantation have signs of cardiac dysfunction

 • Diagnosis: echocardiography with dynamic stress testing w/ pharmacologics or exercise

 • Pathophysiology: myocardial dysfunction 2/2 systemic inflammation; shear stress from portal hypertension → mechanical force on myocardial fibers; other possible mechanisms involve collagen configuration, sodium retention and activation of RAAS

 • Treatment: same as HF management in non-cirrhotic patients

 • Prognosis: largely subclinical and asymptomatic; however poses risk in the presence of stress such as infection, TIPS, or OLT; thus detailed cardiac assessment required prior to interventions



#Cirrhotic #Cardiomyopathy #Cirrhosis #Diagnosis #Management #Summary #Hepatology
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