The Value of Using Echocardiography in Patients of Advanced Liver Disease with Cardio Pulmonary Complications


ABSTRACT:BACKGROUND:Patients with chronic liver disease are liable to get cardio – pulmonary complications, one of these complications is development of pulmonary hypertension ranging from mild to it's sever form – this complication could give some abnormal findings in chest x-ray, electrocardiography but more prominently by echocardiography.OBJECTIVES:To clarify the benefit of using the echocardiogram is detecting pulmonary hypertension prior to the use of invasive methods (catheterization) in patients with advanced liver disease.METHODS:A total of 50 patients with chronic liver diseases (cirrhosis, chronic active hepatitis) their age range is (25-70 years) (mean are 37.07 years), the fifty patients were free from any cardiac or respiratory diseases.The study extending from December 2007-August 2008. All patients went through full history and routine blood test: including complete blood picture, fasting blood sugar, blood urea & screatinne, lipid profile, liver function tests, clinical examination, and investigations included routine blood test, chest x-ray, and electrocardiography, echocardiography (Transthoracie and transoesphageal). The child-Pugh score used for assessing the severity and prognosis of chronic liver disease and it classified into three groups (A, B, C) used in this study.RESULTS:Fifteen patients from the 50 cases (30%) only proved to have cardio-pulmonary changes (i.e. pulmonary hypertension right ventricular hypertrophy and dilatation with the mean value of ≥ 25mm Hg at rest or ≥ 30mm Hg during exertion) those patients were having fatigue in (70%) of them while dysponea, chest pain, cyanosis, syncope were detected in 30%, 10%, 1%, 2% respectively in those cases of pulmonary hypertension with chronic liver disease.CONCLUSION:The use of non invasive methods especially echocardiography were helpful in detecting the presence of pulmonary hypertension in patients with chronic liver disease