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Congestive Hepatopathy

By

Whitney Jackson

, MD, University of Colorado School of Medicine

Reviewed/Revised Jan 2022 | Modified Sep 2022
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Congestive hepatopathy is a backup of blood in the liver, resulting from heart failure.

Severe heart failure Heart Failure (HF) Heart failure is a disorder in which the heart is unable to keep up with the demands of the body, leading to reduced blood flow, back-up (congestion) of blood in the veins and lungs, and/or... read more Heart Failure (HF) causes blood to back up from the heart into the inferior vena cava (the large vein that carries blood from the lower parts of the body to the heart). Such congestion increases pressure in the inferior vena cava and other veins that carry blood to it, including the hepatic veins (which drain blood from the liver). If this pressure is high enough, the liver becomes engorged (congested) with blood and malfunctions.

Most people do not have any symptoms beyond their complaints related to heart failure. In other people, the congested liver causes abdominal discomfort, which is usually mild. The liver (in the upper right part of the abdomen) is tender and enlarged. In severe cases, the skin and whites of the eyes may turn yellow—a disorder called jaundice Jaundice in Adults In jaundice, the skin and whites of the eyes look yellow. Jaundice occurs when there is too much bilirubin (a yellow pigment) in the blood—a condition called hyperbilirubinemia. (See also Overview... read more Jaundice in Adults . Fluid may accumulate in the abdomen—a disorder called ascites Ascites Ascites is the accumulation of protein-containing (ascitic) fluid within the abdomen. Many disorders can cause ascites, but the most common is high blood pressure in the veins that bring blood... read more . The spleen also tends to enlarge. If congestion is severe and chronic, liver damage or even severe scarring (cirrhosis Cirrhosis of the Liver Cirrhosis is the widespread distortion of the liver's internal structure that occurs when a large amount of normal liver tissue is permanently replaced with nonfunctioning scar tissue. The scar... read more Cirrhosis of the Liver ) develops.

Doctors suspect the disorder in people with heart failure who have typical symptoms. Doctors examine the person and do blood tests to determine how well the liver is functioning and whether it is damaged (liver tests Liver Blood Tests Liver tests are blood tests that represent a noninvasive way to screen for the presence of liver disease (for example, viral hepatitis in donated blood) and to measure the severity and progress... read more ) and to evaluate blood clotting. The diagnosis is based on symptoms and results of the examination and blood tests. Congestive hepatopathy is important to identify mainly because it indicates how severe heart failure is.

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