Hepatic Asystole

HEPATIC ASYSTOLE, cardiac failure caused by disease of the liver. Reflex dilation of the heart of gastrointestinal-hepatic origin was described by Potain and Barie in 1869. According to these authors, reflex from the mucous membrane of the bile ducts, causing spasm of the small vessels of the lung with subsequent hypertension in the lesser circulation, leads to weakening of the right heart and its dilation. Experimentally, this hypothesis was confirmed by Arloing and Morel. The clinical picture in some cases gives predominance to painful sensations, similar to angina, with palpitations, tachycardia, or without it. In others, significantly rarer, difficulty in pulmonary circulation with subsequent dilation of the right heart and symptoms of functional insufficiency of the tricuspid valve. Later clinical observations did not confirm the reflex origin of acute heart failure in diseases of the bile ducts (Vaquez). The more complex origin of asystole in cirrhosis of the liver depends on the poor filling of the heart due to hypertension of the portal vein, and partly this asystole depends on the compression and pressure of the femoral and pelvic veins by ascitic fluid. Lit.: Potain P., Clinical Lectures, ed. by the journal 'Contemporary Medicine and Hygiene', 1898; Vaquez, Diseases of the Heart, parts 1 and 2, ed. by 'Practical Medicine', L., 1927; Levin Ya. M. and Pletnev D. D., Fundamentals of Clinical Diagnosis, M.-L., 1928.