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High-Output Congestive Heart Failure Following Transjugular Intrahepatic Portal-Systemic Shunting FREE TO VIEW

Alan C. Braverman; Mark A. Steiner; Daniel Picus; Heather White
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Affiliations: From the Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis,  From the Department of Medicine, Washington University School of Medicine, St. Louis,  From the Department of Radiology, Washington University School of Medicine, St. Louis,  From the Gastroenterology Division, Department of Medicine, Washington University School of Medicine, St. Louis

Affiliations: From the Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis,  From the Department of Medicine, Washington University School of Medicine, St. Louis,  From the Department of Radiology, Washington University School of Medicine, St. Louis,  From the Gastroenterology Division, Department of Medicine, Washington University School of Medicine, St. Louis

Affiliations: From the Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis,  From the Department of Medicine, Washington University School of Medicine, St. Louis,  From the Department of Radiology, Washington University School of Medicine, St. Louis,  From the Gastroenterology Division, Department of Medicine, Washington University School of Medicine, St. Louis

Affiliations: From the Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis,  From the Department of Medicine, Washington University School of Medicine, St. Louis,  From the Department of Radiology, Washington University School of Medicine, St. Louis,  From the Gastroenterology Division, Department of Medicine, Washington University School of Medicine, St. Louis


1995 by the American College of Chest Physicians


Chest. 1995;107(5):1467-1469. doi:10.1378/chest.107.5.1467
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Abstract

A hyperdynamic circulatory state with elevated cardiac output, decreased peripheral vascular resistance, and sodium retention occurs in patients with portal cirrhosis. Surgical portal-systemic shunts and transjugular intrahepatic portal-systemic shunts (TIPS) have been shown to worsen the high-output state in these patients. However, clinical evidence of high-output congestive heart failure has been reported only rarely to complicate cirrhosis. We describe a patient who developed high-output congestive heart failure with markedly elevated filling pressures after TIPS and had complete resolution of heart failure after liver transplantation.


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