Summary
An elderly female with an acute episode of congestive heart failure, unaccompanied by any periods of hypotension, developed fulminant hepatic failure with an accompanying coagulopathy. Attempts to establish an etiology for her acute hepatic insufficiency, other than cardiac failure, proved negative. Fulminant hepatic failure as a consequence of congestive heart failure, without prolonged periods of hypotension preceding alteration in hepatic function, has not heretofore been described. Liver function is adversely effected in congestive heart failure. Hepatic ammonia clearance is impaired in cardiac failure and may be diminished to the point of resulting in hepatic encephalopathy. Coagulopathy is a frequent concomitant of fulminant hepatic failure. Establishing a clear etiology for a coagulopathy in the face of concomitant liver disease is difficult, thus making any therapeutic intervention fraught with peril.
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Dr. Kisloff is supported by a training grant in gastroenterology AM 0567-08 from the National Institutes of Health. The authors wish to express their gratitude to Dr. Harold J. Fallon for his suggestions.
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Kisloff, B., Schaffer, G. Fulminant hepatic failure secondary to congestive heart failure. Digest Dis Sci 21, 895–900 (1976). https://doi.org/10.1007/BF01072084
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DOI: https://doi.org/10.1007/BF01072084