Cirrhotic Cardiomyopathy: What It Is and How to Manage It

If you have advanced liver disease, your heart might start acting up too. That’s called cirrhotic cardiomyopathy – a shaky heart muscle that doesn’t pump as well because the liver is scarred. It’s not a separate disease, just a side‑effect of a sick liver. Knowing the basics can help you catch problems early and keep your heart ticking.

How It Shows Up

The first clue is often a low blood pressure that doesn’t improve when you stand up. You might feel dizzy, tired, or notice swelling in your ankles. Some people get a fast heartbeat at rest. The heart’s ability to relax between beats gets weaker, so doctors call it “diastolic dysfunction.”

Blood tests won’t show the heart issue directly, but high levels of bilirubin or low albumin signal that the liver is struggling, which raises the risk of heart trouble. An ultrasound of the heart (echocardiogram) will reveal a reduced ejection fraction or thickened walls. If you’ve had an episode of fluid in the abdomen (ascites) or liver‑related breathing problems, doctors will often check your heart at the same time.

Ways to Help Your Heart

First, treat the liver. Lowering the pressure in the portal vein with beta‑blockers or reducing fluid with diuretics can ease the heart’s load. If you’re on a sodium‑restricted diet, stick to it – less salt means less water retention, which helps the heart pump easier.

Exercise in short bursts, like a 5‑minute walk, can improve heart muscle strength without overtaxing it. Keep your blood pressure in check; if it’s high, talk to your doctor about safe meds – some blood‑pressure drugs are better for liver patients than others.

Stay on top of infections. A fever can push the heart to work harder, and people with cirrhosis are prone to infections. Vaccines for flu and pneumonia are worth the effort.

Watch your alcohol intake. Even a little alcohol makes liver scarring worse and can sabotage any heart‑helping measures you’re trying.

If symptoms get worse, your doctor might recommend a heart‑specific medication like an ACE inhibitor, but only under close supervision. In severe cases, a liver transplant can reverse the heart problem because a healthy liver restores normal circulation.

Bottom line: cirrhotic cardiomyopathy isn’t a stand‑alone illness, but it can make living with liver disease tougher. Keep an eye on blood pressure, stay active, follow a low‑salt diet, and work with your healthcare team to manage both liver and heart. Small steps now can keep your heart from giving up later.