value of using echocardiography in patients of advanced liver disease with cardio pulmonary complications

ABSTRACT

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. 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. 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 and 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. 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. The use of non invasive methods especially echocardiography were helpful in detecting the presence of pulmonary hypertension in patients with chronic liver disease