Broken heart, broken liver

Cardiomyopathy is one of the few treatable causes of acute liver failure

Rhonda, a previously well and independent 64-year-old woman, presented with a newly diagnosed, idiopathic, dilated cardiomyopathy and pulmonary embolism with an acute liver failure.

This followed an uncomplicated, elective, laparoscopic cholecystectomy for calculi and chronic cholecystitis.

Prior to her surgery, her LFTs were within normal range, and she was discharged home the day after her procedure.

Within a week, Rhonda returned, complaining of worsening shortness of breath on exertion, paroxysmal nocturnal dyspnoea, nausea with epigastric pain radiating to her back, and