Pericardial Effusion and Left Ventricular Dysfunction Associated With Ascites Secondary to Hepatic Cirrhosis

Shah, Arvind; Variyam, Easwaran P.

doi:10.1001/archinte.1988.00380030091018

Cited by 25 publications

(5 citation statements)

References 26 publications

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“…The effusion resolved after cessation of peritoneal dialysis. Shah et al 2 . reported that 17 of 27 patients (63%) with alcoholic cirrhotic ascites had mild to moderate pericardial effusion compared with 3 of 28 controls (11%).…”

Section: Discussionmentioning

confidence: 99%

Hepatic hydropericardium

CHEUNG

Tam

Bartholomeusz

et al. 2003

J of Gastro and Hepatol

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A 41-year-old man with chronic hepatitis C and cirrhosis presented with pericardial effusion and tamponade requiring pericardiocentesis. Nine liters of pericardial fluid was drained with complete resolution of his ascites. He represented with recurrent pericardial effusions despite salt restriction and diuretic therapy. Subsequent radionuclide scans demonstrated a direct connection between the peritoneal and pericardial spaces. A pericardial window was formed but despite this there was recurrence of pericardial effusion and pleural effusion. The patient underwent orthotopic liver transplantation 7 months later and no recurrence of pleural or pericardial effusion was observed following transplantation. We believe this is the first case report of pericardial effusion secondary to cirrhotic ascites and a communication between the peritoneal and pericardial cavities.

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Section: Discussionmentioning

confidence: 99%

Hepatic hydropericardium

CHEUNG

Tam

Bartholomeusz

et al. 2003

J of Gastro and Hepatol

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“…Two series described fibrinous pericarditis in cirrhotic patients 83 , 84 . The reported incidence of pericardial effusions in patients with cirrhosis shows a wide range, 32–63%, and seems to correlate with the degree of liver failure 85–87 . The variable prevalence likely reflects the different proportions of patients with severe cirrhosis in these series.…”

Section: Endocarditis and Pericarditismentioning

confidence: 94%

Cardiopulmonary dysfunction in cirrhosis

Liu

Lee

1999

J of Gastro and Hepatol

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Cirrhosis is associated with several circulatory abnormalities. These include hyperkinetic systemic and splanchnic circulation, hepatopulmonary syndromes including pulmonary hypertension, and cirrhotic cardiomyopathy. Hepatopulmonary syndrome generally refers to hypoxaemia seen in patients with chronic liver disease and appears to be relatively common, although often subclinical. However, significant pulmonary hypertension occurs in 0.2-0.7% of cirrhotic patients. Nitric oxide and/or other vasodilators appear to be involved in the pathogenesis of hepatopulmonary syndrome through induction of pulmonary capillary dilatation which increases the alveolar-arterial oxygen gradient. Cirrhotic cardiomyopathy refers to abnormal left ventricular function which is manifested under conditions of physiological or pharmacological stress. The emergence of liver transplantation as an effective treatment for end-stage liver disease has led to recognition of previously subclinical cardiomyopathy and congestive heart failure accounts for significant morbidity and mortality after this procedure. Diminished myocardial beta-adrenergic receptor function has been shown to play an important role in the pathogenesis of this condition. The contributions of other factors including nitric oxide, catecholamines and membrane fluidity changes are under investigation. Cirrhotic patients also have an increased incidence of other cardiac abnormalities, such as endocarditis and pericardial effusions.

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“…In patients with alcoholic liver disease, Rector et al (50,55,56) found a normal-sized left ventricle, enlarged left atrium and diameters of right atrium and right ventricle within the normal range. Other studies using the same technique, however, have reported increased left ventricular end-diastolic and end-systolic volumes (57)(58)(59)(60)(61)(62). By the use of radionuclide angiography, Wong et al (52) recently reported normal values of left ventricular systolic and diastolic volumes, including the stroke volume in patients with alcoholic cirrhosis.…”

Section: The Cirrhotic Heartmentioning

confidence: 98%