Overview of Hepato-cardial syndrome
Hepato-cardial syndrome (HCS) is a series of cardiac clinical symptoms, signs and electrocardiogram abnormalities caused by liver diseases such as palpitations, angina pectoris, cardiac insufficiency and arrhythmia. Clinical manifestations include palpitations, chest discomfort, hypotension, and cardiac rhythm disorders. The treatment of this disease is the key to the original disease of the liver, and cardiovascular symptoms can be treated symptomatically.
Etiology
When suffering from liver disease, it can be caused by ① myocardial toxicity produced by hepatocyte insufficiency; ② myocardial inflammation; ③ fever; ④ abnormalities of vegetative nerve function; ⑤ myocardial metabolism and anemia caused by myocardial ischemia and vasomotor disorder; ⑥ myocardial local electrolyte imbalance; ⑦ plasma protein abnormality; ⑧ myocardial metabolism abnormality; ⑨ endocrine dysfunction; ⑩ neurological reflex mechanism is affected, resulting in peripheral circulatory regulatory dysfunction and many other reasons that contribute to the development of this disease. There are many reasons for the development of this syndrome, such as dysfunction.
Symptoms
Patients have clear symptoms and signs of liver disease, along with palpitations, chest tightness, fatigue, angina pectoris, cardiac insufficiency and other symptoms, normal or low blood pressure, lower limb edema, and various cardiac arrhythmias, such as preterm systole, paroxysmal supraventricular tachycardia, atrial flutter, atrial fibrillation, and so on. ECG changes: low voltage, prolongation of P-R interval or Q-T interval, changes in T-wave and S-T, etc. Blood electrolytes are normal.
Examination
1. Liver function tests
Liver function is obviously abnormal, with elevated transaminases and inverted A/G. Urea nitrogen is mildly or moderately elevated, and blood potassium, sodium and calcium are lowered.
2. Electrocardiogram
Arrhythmia, ST-segment downshift, T-wave inversion and flattening, prolongation of Q-T interval, appearance of U-wave, conduction disorder, etc. can be seen.
Diagnosis
The diagnosis can be made based on the history of hepatobiliary system diseases and the symptoms of the circulatory system, combined with the results of liver function tests and electrocardiogram.
Differential diagnosis
Organic heart disease, such as coronary atherosclerosis, myocarditis and cardiomyopathy should be excluded.
Treatment
1. Mainly treat the primary liver disease and protect liver function to reduce or prevent the effect of liver disease on the heart. Correct electrolyte imbalance and apply hepatocyte growth promoter, etc.
2. Symptomatic treatment with coronary artery dilating drugs and antiarrhythmic drugs.
3. Prevent and control intracranial hypertension. Dehydration treatment for those who have cerebral edema.