Cardiac Manifestations of Viral Hepatitis

A retrospective study was performed on 30 consecutive autopsied patients who died of acute viral hepatitis. Clinical evidence of cardiac disease included prolonged hypotension, progressive cardiomegaly, pulmonary edema, and sudden death. Electrocardiographic abnormalities included low voltage, left axis deviation, T-wave abnormalities, and cardiac arrhythmias. Fourteen episodes of cardiac arrhythmia occurred in eight patients, and 2 patients died suddenly of cardiac asystole. Pathologic findings in the heart included widespread petechial hemorrhage, inflammatory infiltration of lymphocytes, fatty degeneration of the heart, flabby dilated ventricles, and edema of the subendocardial connective tissue. Hospitalized patients with viral hepatitis may benefit from ECG monitoring and close observation for evidence of cardiac failure.