title: The liver in heart failure.
abstract: Severe congestive heart failure is associated with two distinct forms of liver dysfunction: jaundice that is related to passive congestion and acute hepatocellular necrosis that is caused by impaired perfusion. Cardiac cirrhosis (fibrosis) may result from prolonged recurrent congestive heart failure. Ischemic hepatitis (shock liver) usually manifests as asymptomatic elevation of the serum aminotransferase levels after an episode of hypotension, although the clinical presentation may mimic that of acute viral hepatitis. In most cases, ischemic hepatitis is of little clinical consequence and is self-limited. Acute liver failure may occur in patients with preexisting cirrhosis, severe chronic heart failure, or sustained hepatic ischemia.
authors.affiliation: Department of Medicine, Harvard Medical School, Gastrointestinal Unit, Massachusetts General Hospital, Boston, MA, USA. friedman.lawrence@mgh.harvard.edu
authors.forename: Cosmas C
authors.initials: CC
authors.lastname: Giallourakis
authors.forename: Peter M
authors.initials: PM
authors.lastname: Rosenberg
authors.forename: Lawrence S
authors.initials: LS
authors.lastname: Friedman
mesh_terms: D000818:Animals; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D007511:Ischemia / Q000209:etiology; D008099:Liver / Q000098:blood supply* / Q000473:pathology; D008102:Liver Circulation; D008107:Liver Diseases / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D015427:Reperfusion Injury / Q000209:etiology