| Pulmonary oedema after therapeutic ascitic paracentesis: a case report and literature review of the cardiac complications of cirrhosis. | |
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MedLine Citation:
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PMID: 19801941 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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In this study, we describe the development of acute pulmonary oedema and cardiac arrest after therapeutic ascitic paracentesis, in a gentleman with decompensated liver cirrhosis. There was no previous history of cardiorespiratory symptoms or disease. Postmortem examination revealed oedematous and congested lungs with bilateral pleural effusions; in addition, the right heart was dilated and congested. Micronodular cirrhosis was present with histological features of alpha1 antitrypsin deficiency. This is the first study of acute cardiac decompensation after large volume paracentesis. Owing to the postmortem findings, underlying asymptomatic cardiorespiratory disease may have been present. Cirrhosis is associated with cardiovascular complications including cirrhotic cardiomyopathy, portopulmonary hypertension and hepatopulmonary syndrome which may manifest or worsen under situations of haemodynamic stress. This report thus raises the question whether routine screening for cardiovascular abnormalities is warranted in patients with decompensated cirrhosis, particularly before the procedures such as paracentesis that impose significant haemodynamic strain. |
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Authors:
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Abhishek Sharma; Andrew Fletcher; George R Lipscomb |
Publication Detail:
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Type: Case Reports; Journal Article; Review |
Journal Detail:
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Title: European journal of gastroenterology & hepatology Volume: 22 ISSN: 1473-5687 ISO Abbreviation: Eur J Gastroenterol Hepatol Publication Date: 2010 Feb |
Date Detail:
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Created Date: 2010-01-11 Completed Date: 2010-03-12 Revised Date: 2010-07-20 |
Medline Journal Info:
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Nlm Unique ID: 9000874 Medline TA: Eur J Gastroenterol Hepatol Country: England |
Other Details:
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Languages: eng Pagination: 241-5 Citation Subset: IM |
Affiliation:
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Department of Gastroenterology, Royal Bolton Hospital, Lancashire, Bolton BL4 0JR, UK. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Aged Ascites / etiology, physiopathology, therapy* Autopsy Cardiomyopathies / etiology Electrocardiography Fatal Outcome Heart Arrest / etiology*, physiopathology Heart Failure / diagnosis, etiology*, physiopathology Hemodynamics Humans Liver Cirrhosis / complications*, physiopathology Male Multiple Organ Failure / etiology Paracentesis / adverse effects* Pleural Effusion / etiology Pulmonary Edema / etiology*, radiography |
| Comments/Corrections | |
Comment In:
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Eur J Gastroenterol Hepatol. 2010 Aug;22(8):1024
[PMID:
20631544
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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