Profound Electrocardiogram Changes in a Patient With Liver Cirrhosis

Two years after the diagnosis of cirrhotic-stage primary sclerosing cholangitis, a 41-year-old man underwent successful liver transplantation. Three months later he experienced progressive shortness of breath, chest pain, and episodes of exertional syncope. Of note, during the 2-year pretransplant period, the patient had no cardiac complaints, and an echocardiogram performed a few months before the liver transplantation was normal.Figure 1 demonstrates 2 electrocardiograms (ECGs) of the patient.Figure 1A was obtained before the liver transplantation, andFigure 1B was recorded 3 months after the liver transplantation, on development of new cardiovascular symptoms. Note the profound changes both in the QRS morphologies and the ST-T segments between the 2 ECGs.
Source: JAMA Internal Medicine - Category: Internal Medicine Source Type: research