Cardio-Hepatology - Chapter 9: Passive liver congestion and hypoxic hepatitis

Chronic right-sided heart failure has deleterious effects on many organ systems, and the liver is no exception. Passive hepatic congestion not only can precipitate impaired hepatic synthetic function and hepatic fibrosis, but it can also predispose the liver to more severe acute injury in the setting of circulatory compromise, an entity known as hypoxic hepatitis. In this chapter, we discuss the pathophysiology, clinical manifestations, and management of passive liver congestion and hypoxic hepatitis: two closely related entities on a spectrum of liver disease associated with right heart failure.