Chylous ascites as the main manifestation of left ventricular dysfunction: a case report.
BACKGROUND
Ascites is one of the most common complications of liver diseases, even though in 15% of the cases it is related to extrahepatic diseases; 3% are of cardiac nature and they appear associated with signs and symptoms of heart failure.


METHODS
A 70 year old man was admitted with more than one year history of abdominal distension and a weight gain of 10 kilograms. He is asymptomatic and walks 2000-3000 meters a day without angor or dyspnea. The physical examination shows moderate abdominal distension, with no hepatosplenomegaly or edema, and there is mild jugular vein distension. The studies performed (complete laboratory work up, paracentesis, liver biopsy, echocardiogram, intrahepatic pressure measurements, etc.) showed a chylous ascites related to portal hypertension, and left ventricular dysfunction was the only probable cause found.


CONCLUSIONS
Asymptomatic heart dysfunction can mimic liver disease and should be kept in mind as a cause of chylous ascites.
Ridruejo
Ezequiel
E
Hepatology Section, Department of Internal Medicine, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno, Buenos Aires, Argentina. eridruejo@cemic.edu.ar
Mandó
Oscar G
OG
D000368:Aged; D002303:Cardiac Output, Low / Q000209:etiology / Q000473:pathology; D002915:Chylous Ascites / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications; D008099:Liver / Q000473:pathology; D008297:Male; D036542:Tomography, Spiral Computed; D018487:Ventricular Dysfunction, Left / Q000150:complications*