Cardiac cirrhosis refers to a spectrum of liver disorders that dysfunction in the heart can cause. It can occur when issues with blood circulation congest the liver and cause injury.

Without healthy circulation, the liver is unable to function normally. Cardiac cirrhosis commonly has a link with heart failure and other heart conditions. Specifically, problems in the right side of the heart can result in fluid buildup in the liver, affecting blood flow in the organ.

It can be challenging to diagnose cardiac cirrhosis as the condition sometimes causes no symptoms, and other liver disorders a person may be experiencing can mask it. Ultimately, treatment of cardiac cirrhosis will likely depend on the underlying heart condition.

This article provides information on the causes, symptoms, and diagnosis of cardiac cirrhosis.

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“Cardiac cirrhosis” — sometimes called congestive hepatopathy — describes liver disorders that occur due to underlying heart dysfunction.

The liver relies on normal blood circulation and heart function to maintain healthy venous blood pressure and oxygen levels.

When the right side of the heart is malfunctioning or failing, the liver becomes congested with blood the heart cannot pump through the right atrium. If the heart struggles to pump blood due to heart failure, the blood pressure in the veins may increase, causing fluid buildup. This is cardiac cirrhosis.

Fluid buildup in the liver can cause scarring and injury to the hepatocytes. Hepatocytes are the cells that make up most liver tissue and are vital to keeping the organ functioning healthily.

Cardiac cirrhosis is often asymptomatic, meaning the person with the condition has no noticeable symptoms.

However, some people may experience the following, which can relate to liver dysfunction:

These symptoms could also relate to the underlying heart condition.

Symptoms of heart failure commonly include:

Any condition or problem that causes the right ventricle in the heart to fail or stop working correctly can cause cardiac cirrhosis. The right ventricle is the part of the heart that pumps filtered blood from the liver via a vein called the inferior vena cava.

Issues within the right ventricle are usually due to an underlying heart condition.

Heart failure in the right side of the heart causes increased pressure in the right atrium, the upper right heart chamber. Ultimately, an increase in venous pressure in the liver causes the veins to become congested, resulting in damage to the organ.

Heart conditions that commonly have a link to cardiac cirrhosis include:

Certain congenital heart diseases can also cause cardiac cirrhosis.

Diagnosing cardiac cirrhosis can be challenging as the condition sometimes causes no symptoms and can go unnoticed due to other causes of liver damage.

Doctors usually suspect that someone has liver dysfunction after abnormal results from a liver function test reveal high enzyme levels.

Further evaluation will be required if there are abnormal liver enzyme test results or examination findings, such as an enlarged or tender liver. Initial tests include abdominal imaging tests, such as an ultrasound. Diagnosing cardiac cirrhosis, however, requires an echocardiogram.

An echocardiogram is a noninvasive heart ultrasound that can help identify if right-sided heart failure is present. It can also allow doctors to identify underlying abnormalities, such as:

  • valvular heart disease, a condition where one or more of the heart valves is damaged
  • cardiomyopathy, a disease of the heart muscle that makes it harder to pump blood in the body
  • pericardial disease, which affects the pericardium, the structure containing the heart

The treatment for cardiac cirrhosis depends on the underlying condition that has damaged the liver. Many methods treat right-sided heart failure depending on the cause and an individual’s circumstances.

Treating right-sided heart failure

Diuretics are a mainstay therapy for chronic right-sided heart failure.

A 2020 review suggests that diuretics may benefit those with heart failure that has led to cardiac cirrhosis. This is due to diuretics reducing fluid throughout the body, helping decongest the liver. Aldosterone antagonists are a type of diuretic.

Doctors may prescribe other medications depending on the underlying cause of right-sided heart failure.

Learn more about treating right-sided heart failure.

Lifestyle changes

The following lifestyle changes may help keep both the heart and liver healthy:

The outlook for individuals with cardiac cirrhosis depends on the condition’s underlying cause and how effectively doctors can manage it.

If an individual’s heart function improves, it may also be possible for cirrhosis to improve. However, more advanced cases can have severe consequences and can be life threatening.

Heart failure

There is currently no cure for heart failure, and those with the condition will likely need treatment for the rest of their lives. However, certain treatments can improve a person’s quality of life and allow them to live longer.

A 2017 review reports the estimated one-year survival rate for those with chronic heart failure to be 80–90% and the five-year survival rate to be around 50–60%.

“Cardiac cirrhosis” refers to a range of liver disorders that are a result of a cardiac condition, often right-sided heart failure. This condition causes congestion in the liver and damages parts of the organ that are vital for its healthy function.

It can be difficult for doctors to diagnose cardiac cirrhosis due to a potential lack of symptoms or the presence of other liver disorders.

The treatment and outlook for those with cardiac cirrhosis depend on the underlying cardiac condition and subsequent treatment. Certain lifestyle changes can help with maintaining heart and liver health.

Konstam MA, et al. (2018). Evaluation and management of right-sided heart failure: A scientific statement from the American Heart Association.