High-output congestive heart failure following transjugular intrahepatic portal-systemic shunting.
case_report · Level V
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Abstract
A hyperdynamic circulatory state with elevated cardiac output, decreased peripheral vascular resistance, and sodium retention occurs in patients with portal cirrhosis. Surgical portal-systemic shunts and transjugular intrahepatic portal-systemic shunts (TIPS) have been shown to worsen the high-output state in these patients. However, clinical evidence of high-output congestive heart failure has been reported only rarely to complicate cirrhosis. We describe a patient who developed high-output congestive heart failure with markedly elevated filling pressures after TIPS and had complete resolution of heart failure after liver transplantation.
Medical subject headings
- Cardiac Output, High
- Heart Failure
- Liver Cirrhosis, Alcoholic
- Portasystemic Shunt, Surgical