Heart Problems in Children With Chronic Liver Disease

Chronic liver disease (CLD) in the pediatric age group involves progressive destruction and regeneration of liver parenchyma. The etiology in children encompasses a broad spectrum of disorders, including infections, autoimmune hepatitis, viral hepatitis, Wilson's disease, and biliary atresia. Prognosis and treatment are heavily influenced by the underlying etiology, necessitating thorough clinicopathological evaluation. Among the severe reported complications of CLD, such as portal hypertension, malnutrition, and hepatorenal syndrome, cardiac complications are highly significant. This study specifically investigates the following cardiac issues: * Portopulmonary hypertension: Defined as a mean pulmonary arterial pressure \>25 mmHg and pulmonary capillary wedge pressure \<15 mmHg, often presenting with dyspnea, fatigue, orthopnea, or chest pain. It is thought to be triggered by increased pulmonary blood flow secondary to portal hypertension, which leads to vascular injury and remodeling. * Cirrhotic cardiomyopathy: A hemodynamic consequence of portal hypertension characterized by systolic and/or diastolic dysfunction, left ventricular hypertrophy, and electrophysiological disturbances. The underlying mechanism involves myocardial wall stiffness resulting from fibrosis and subendothelial edema. * Cardiac repolarization abnormalities: Prolongation of the corrected QT (QTc) interval is the most common finding, with its prevalence increasing in parallel with the severity of cirrhosis. Up to 60% of patients with end-stage liver disease exhibit an abnormal QTc. This descriptive cohort study aims to systematically assess these cardiac outcomes across different liver disease groups. Data collection involves comprehensive clinical histories, including age at onset, disease type semiology, and detailed physical examinations covering general, abdominal, cardiac, neurological, and chest assessments.