Cardiac Cirrhosis and Congestive Hepatopathy Differential Diagnoses

Updated: Jan 03, 2020
  • Author: Mansoor Arif, MD; Chief Editor: Gyanendra K Sharma, MD, FACC, FASE  more...
  • Print
DDx

Diagnostic Considerations

Important considerations include the following:

  • Diagnose a correctable underlying cause of cardiac cirrhosis . For example, patients with alcoholism and cardiac disease who present with ascites may be misdiagnosed by attributing liver derangements to alcoholic cirrhosis.

  • Search for concomitant hepatobiliary disease in patients with either significantly or persistently elevated hepatic transaminases, alkaline phosphatase, or total bilirubin levels. For example, collecting a detailed social history may lead to the diagnosis of acute hepatitis B infection and prevent progression to end-stage liver failure.

  • Do not perform unnecessary liver biopsies.

  • Transjugular intrahepatic portosystemic shunt (TIPSS) is contraindicated in cardiac cirrhosis. It may precipitate acute right heart failure from an acute increase in pulmonary arterial pressure.

  • Adjust hepatically cleared medications.

Other conditions to consider in patients with cardiac cirrhosis and congestive hepatopathy include the following:

  • Biventricular congestive heart failure

  • Rright ventricular congestive heart failure

  • Hepatic veno-occlusive disease

  • Ischemic hepatitis

Differential Diagnoses