OGH Reports 2017; 6(1): 28-30 Peer Reviewed Journal in Oncology, Gastroenterology and Hepatology www.oghreports.org | www.journalonweb.com/ogh OGH Reports, Vol 6, Issue 1, Jan-Jun, 2017 28 Case Report INTRODUCTION Chronic right sided congestive heart failure may cause chronic liver injury and cirrhosis of liver but is very uncommon. In long term right heart failure there is elevated venous pressure that is transmitted to liver sinusoids via inferior vena cava and hepatic veins. is leads to long term passive congestion and relative ischemia due to poor circulation eventually leading to necrosis and fibrosis of liver predominantly of centrilobular region. Patient generally presents with clinical features of congestive heart failure and portal hypertension but very rarely presents with variceal hemorrhage or encephalopathy. [1] But our case patient presented with evidence of variceal hemorrhage. Also the overall prognosis of cardiac cirrhosis is not well established and treatment of cardiac cirrhosis is mainly aimed at managing underlying heart failure so it becomes important to distinguish it from other cause of cirrhosis. [1] CASE HISTORY A 50 year male, farmer, chronic smoker presented with progressively increasing abdominal distension for last 6 months, malena for 2 months, Pedal edema for 1 month and constipation for 15 days and a episode of hematemesis. ere was also history of anorexia, nausea and easy fatigability and presently presented due to massive abdominal distension leading to diffi- culty in breathing and episode of hematemesis. On repeated enquiry he also revealed of chronic cough and breathlessness with winter exacerbation for last 10 years and episodes of pedal edema relieving aſter Cardiac Cirrhosis–An Uncommon Manifestation of Common Disease ABSTRACT Background: Chronic Right Heart failure is known to cause Liver Cirrhosis but it is rare. Here we are reporting the case of cardiac cirrhosis presented to us with signs of Liver Failure. Case Report : 50 year male, farmer, chronic smoker presented with progressive abdominal distension and episodes of malena since 6 months and an episode of hematemasis. On work up Liver cirrhosis was diagnosed but cause for cirrhosis was not established and on general examination pulse was irregular and features of pulmonary hypertension were present. On reviewing he revealed history of chronic cough and breathlessness with winter exacer- bations and pedal edema. Chest X-ray suggested cardiomegaly, ECG suggested low voltage complex with poor R wave progression and 2-D Echo suggested pulmonary hypertension with tricuspid regurgitation with right sided dysfunction suggesting cardiac cause for cirrhosis. Conclusion : Chronic Right Heart Failure is known but rare cause of Liver cirrhosis. Key words: Heart Failure, Cardiac Cirrhosis. Jaideep Khare 1* , Prachi Srivastava 2 , Jyoti Wadhwa 1 , Prasun Deb 1 Jaideep Khare 1* , Prachi Srivastava 2 , Jyoti Wadhwa 1 , Prasun Deb 1 1 Department of Endocrinology, Krishna Institute of Medical Sciences, Secunderabad, INDIA. 2 Department of Dermatology, Krishna Institute of Medical Sciences, Secunderabad, INDIA. . Correspondence Dr. Jaideep Khare, MD Medicine, DNB Super Speciality Resident, Dept. Of Endocrinology, Krishna Institute of Medical Sciences, Secunderabad, INDIA. Phone no: 09177816611 Email: drjaideepkhare@yahoo.com History • Submission Date: 24-05-2016; • Review completed: 30-08-2016; • Accepted Date: 12-09-2016. DOI : 10.5530/ogh.2017.6.1.7 Article Available online http://www.oghreports.org/v6/i1 Copyright © 2016 Phcog.Net. This is an open- access article distributed under the terms of the Creative Commons Attribution 4.0 International license. Cite this article: Khare J, Srivastava P, Wadhwa J, Deb P. Cardiac Cirrhosis–An Uncommon Mani- festation of Common Disease. OGH Reports. 2017;6(1):28-30. local medicine. ere was no history of alcoholic intake, high risk sexual behaviour, Jaundice, tubercu- losis, long term drug or herbal intake, surgery or blood transfusion. ere was no significant family history. Examination On general examination patient was cooperative and well oriented with poor nutrition. Pallor and Bi-Pedal pitting edema present. Cyanosis, clubbing, icterus, lymphadenopathy absent. Pulse- 70/min irregular, normovolumic, normal in character and vessel wall normal. Blood pressure- 100/ 70 mmHg Neck veins engorged and pulsatile and jugular venous pressure raised with CV wave form. On abdominal examination, abdomen was distended diffusely with eversion of umbilicus and prominent veins in flanks and epigastrium with blood flow from below upwards. Abdominal striae seen. ere were no scar mark. No superficial tenderness pres- ent. Spleenomegaly of 4 c.m., firm, non-tender with smooth surface present. Liver not palpable no other lump present. Fluid thrill present. On cardiovascular examination precordium seemed to be normal. Apex beat in 5 th intercostal space 2 cm. Lateral to mid clavicular line normal in character. rill or para-sternal heave absent. On auscultation 1 st and 2 nd heart sound audible with loud pulmonary component of 2 nd heart sound. e holosystolic, high-pitched, blowing murmur of tricuspid insuffi-