Right-sided heart failure as a first presentation of portopulmonary hypertension

Introduction. Pulmonary artery hypertension and right ventricular failure are potentially fatal complications that can develop in patients with portal hypertension. The objective of this case report was to a patient end-stage liver disease, pulmonary heart failure. Case outline. A 57-year-old man admitted the Cardiology Department tertiary referral hospital due signs right-sided failure, ascites, pleural effusions, pretibial edema. had history alcohol abuse, arterial hypertension, gout. Just prior admission, abdominal ultrasound revealed granular structure, as well ascites. Laboratory tests showed microcytic anemia, values transaminases below referent, hypoalbuminemia, low creatinine clearance. Echocardiography ventricle Right catheterization unraveled precapillary but thoracic CT scan thoracocentesis excluded underlying illness. Treatment continued at Gastroenterology hospital. Abdominal diagnosed cirrhotic liver, treated symptomatic therapy, developed acute-on-chronic renal eventually died. Conclusion. Multidisciplinary approach is very important distinguish portopulmonary early course because evolution sided precludes these from adequate lifesaving therapy.