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Hepatic Congestion | Cause | Prevention | Treatment | Medication

Updated: Jun 1, 2020

Increased systemic venous pressure from any cause leads to hepatic congestion. The liver becomes enlarged, pulsatile, and tender. Transaminases, alkaline phosphatase, and conjugated (direct) bilirubin become moderately elevated. Occasionally, jaundice and an elevated prothrombin time occur.

Hepatic venous congestion (Passive Hepatic Congestion):

Congestive hepatopathy is diffuse venous congestion within the liver that results from right-sided heart failure (usually due to cardiomyopathy, tricuspid regurgitation, mitral insufficiency, cor pulmonale, or constrictive pericarditis).

Pathology Etiology Congestive hepatopathy resulting from passive hepatic congestion is caused by stasis of blood within the liver parenchyma due to compromise of hepatic venous drainage. Prolonged exposure to elevated hepatic venous pressure may lead to liver fibrosis and cirrhosis.

Underlying conditions include:

  • Pulmonary hypertension

  • Tricuspid regurgitation

  • Constrictive pericarditis

  • Restrictive cardiomyopathy

  • Congenital heart disease, especially those treated with a Fontan procedure