ABSTRACT
This chapter reviews the phenomena of altered cardiac function in the presence of acute and chronic liver disease. The heart is generally directly affected in typical cases of acute viral hepatitis. However, in severe or fulminant viral hepatitis, cardiovascular derangement has been well documented and takes, forms. Moreover, old and recent studies have suggested that bile salts, bilirubin, some other component of icteric serum may exert toxic or irritant effects on cardiac tissue, and in particular may be important in inducing sinus bradycardia, conduction defects. Cholestasis is invariably associated with a decrease in the total peripheral resistance which is a stimulus for reflex tachycardia. The absence of significant changes in heart rate in cholestatic patients animals may, in fact, be a reflection of the inability of the heart to respond to sympathetic stimulation. Hemodynamic effects of portocaval shunts have also been studied in cirrhotic animals.
