On analysing for correlation and associations, it was found that patients of cirrhosis having ECG abnormalities (QTc interval prolongation), increased systolic dysfunction, increased diastolic dysfunction, decreased cardiac output
, decreased cardiac index and increase in proBNP levels were significantly associated (p value <0.
Decreased cardiac output
may cause an S3 and/or S4 on auscultation of heart sounds, but blood pressure is a more immediately relevant assessment.
In conditions with a fixed ventricular outflow obstruction it is not only the decreased cardiac output
that plays a role, but also a reflex vasodilation or orthostatic hypotension.
The decreased cardiac output
stimulates sympathetic activity and blood volume expansion via the activation of the reninangiotensin-aldosterone axis.
It's likely that anergia is related to the decreased cardiac output
and low blood pressure often found in heart failure.
A patient who is hypovolemic, or a patient who has decreased cardiac output
from an MI, will exhibit a decrease in the systolic pressure.
However, in fulminant cases, impaired venous return and decreased cardiac output
might result in potentially fatal hypotension.
1) The exact mechanism of syncope is not known but it is postulated that it may be due to decreased stroke volume and decreased cardiac output
which thus cause decreased cerebral perfusion and syncope.