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Does liver cirrhosis cause swelling above the wrists?

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Patient's Query

Hello doctor,

I am suffering from swelling in my body for two years, especially above my wrists. My liver enzymes ALT and AST have been slightly elevated. I am abnormally exhausted and have had a habit of consuming wine, one bottle per day for nearly thirty years. I was also diagnosed with fatty liver and underwent scans which revealed severe liver disease. Recently I underwent an ultrasound and mild fatty liver was detected. Can cirrhosis of the liver be detected in an ultrasound? I am concerned about the swelling, and fatigue and also doubtful of having liver cirrhosis. Kindly help.

Thank you.

Answered by Dr. Sagar Ramesh Makode

Hello,

Welcome to icliniq.com.

I can understand your concern.

Ultrasound is an observer-dependent investigation for liver cirrhosis and many times, it can miss. The next appropriate step could be getting your fibro scan done, which is a noninvasive and sensitive investigation for cirrhosis, or getting a repeat ultrasound done with a special focus on the echo texture of the liver. This is important, as you have a setting of cirrhosis. Liver enzymes may not be elevated or mildly elevated in cirrhosis.

The following are the possible causes for the elevation of liver enzymes:

  1. Anemia (decreased levels of hemoglobin).
  2. Renal issues.
  3. Alcohol-induced heart damage.

I advise you to follow the below-mentioned instructions:

  1. Get electrocardiogram, echocardiogram and fibroscan (transient elastography) tests done.
  2. Get checked for serum albumin levels, hemogram, renal function test, and thyroid profile.
  3. Avoid consuming alcohol and smoking.

I hope this information will help you.

Thank you.

Patient's Query

Hello doctor,

Thank you for the reply.

I underwent open heart surgery 15 years ago and noticed abnormalities in getting an electrocardiogram with a slight depression on the lower part. My BP has been elevated and I was prescribed hydrochloride 25 milligrams. My heartbeats are felt out of my chest and have panic attacks when I take this tablet. It occurred last week with pressure on my chest and shortness of breath. My ankles and legs swell sometimes but more in my wrists. I think all the physicians are missing a part of the diagnosis of my condition. I am concerned that I am suffering from chronic heart failure and would like to know the blood investigations that can diagnose the condition properly. I already quit consuming alcohol to see if that helps. Kindly suggest.

Thank you.

Answered by Dr. Sagar Ramesh Makode

Hello,

Glad to have you back at icliniq.com.

As you mentioned about undergoing open heart surgery, heart disease can become the likely cause for the swelling. Electrocardiogram may show abnormalities, but will not be very assertive. Heart disease can secondarily damage the liver leading to cirrhosis. Still, other investigations which are mentioned above will help to rule out other coexistent diseases. I suggest you follow the below-mentioned instructions:

  1. Get a repeat echocardiogram test done to look for heart functioning if not done recently.
  2. Blood investigations include renal and liver function tests, hemoglobin, and serum albumin.
  3. Continue with the tablet Lasix (Furosemide)20 milligrams once a day.
  4. Restrict fluid intake like tea, coffee, and water, along with salt intake.
  5. The fluid restriction will resolve the swelling.

I hope this information will help you.

Thank you.

Answered byDr. Sagar Ramesh Makode

Medically reviewed byiCliniq medical review team

Published At October 10, 2023
Reviewed AtOctober 10, 2023

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Dr. Sagar Ramesh Makode

Cardiology

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