Q: Cirrhotic cardiomyopathy is usually due to

A) Secondary to underlying ETOH abuse
B) Itself is a primary disease
C) Due to hypoalbunemia of cirrhosis 
D) Due to frequent sepsis in cirrhosis
E) Due to Budd-Chiari Syndrome


Answer:  B 

 Cirrhotic cardiomyopathy is an independent disease found in cirrhosis. It is different from alcoholic cardiomyopathy. It is least understood of all cardiomyopathies. It is kind of a diagnosis of exclusion manifested as impaired contractile responsiveness to stress and/or diastolic dysfunction. Electrical abnormalities include QT interval prolongation, electrical and mechanical dyssynchrony, and chronotropic incompetence. One of the hallmark is the dilated left atrium but normal LV cavity size in most cases.


References: 

1.  Milani A, Zaccaria R, Bombardieri G, et al. Cirrhotic cardiomyopathy. Dig Liver Dis 2007; 39:507. 

2. Møller S, Henriksen JH. Cirrhotic cardiomyopathy. J Hepatol 2010; 53:179. 

3. Zardi EM, Abbate A, Zardi DM, et al. Cirrhotic cardiomyopathy. J Am Coll Cardiol 2010; 56:539.

4. Timoh T, Protano MA, Wagman G, et al. A perspective on cirrhotic cardiomyopathy. Transplant Proc 2011; 43:1649.