Abstract
Heart failure (HF) is defined as the lack of systemic perfusion to fulfil the body's metabolic demands. It is often caused by ventricular pump malfunction but may rarely appear with signs of a noncardiac illness, such as hepatic dysfunction. The fundamental pathophysiology implicated in HF-related hepatic dysfunction is either passive congestion due to elevated filling pressures or decreased cardiac output and the implications of poor perfusion. Passive hepatic congestion caused by increased central venous pressure can result in elevated liver enzymes as well as direct and indirect blood bilirubin. Impaired perfusion due to reduced cardiac output may be accompanied with abrupt hepatocellular necrosis and significant increases in serum aminotransferases. Cardiogenic ischaemic hepatitis ("shock liver") can develop after an episode of severe hypotension in individuals with acute HF.
