Cardiac abnormalities in patients with cirrhosis

Cardiac abnormalities have been studied by many researchers.Advanced liver cirrhosis is associated with an increase in blood volume, a reduction in systemic vascular resistance, and an increase in cardiac output. How this hyperkinetic circulation affects cardiac function and structure has been incompletely described. Patients with cirrhosis, who have overt cardiac dysfunction, may or may not manifest clinically with symptoms or signs. All patients with cirrhosis of liver should be screened for structural and functional cardiac abnormalities, irrespective of age, sex or cause of cirrhosis. Increased levels of serum bilirubin, INRand serum creatinine are associated with higher degree of cardiac abnormalities. Increase inMELDʹscriteria score is directly proportional to the increase in risk of cardiac abnormalities. Patients who are on transplant recipient list should be screened for latent cardiac abnormalities, so as to prevent death due to arrhythmias. Patients with structural or functional cardiac abnormalities before transplant should be closely monitored for worsening of cardiac function after the transplantation of liver. Cirrhosis was seen predominantly in older age group with 94% of patients > 40 yrs, of which 66%were in between 41 and 60 yrs of age. Cirrhosis of liver was predominantly seen in males i.e. 31 cases (62%) compared to females 19 cases (38 %). The commonest cause of cirrhosis was chronic alcoholism, followed by viral hepatitis. ECG changes seen in 44 % of the cases were long QTc interval. Functional cardiac dysfunction (96%) was highercompared to structural cardiac abnormality (66%).