{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T10:41:54Z","timestamp":1775558514268,"version":"3.50.1"},"reference-count":18,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,10,10]]},"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:p>We present the case of a female patient in her 40s who presented with jaundice, orthopnoea, paroxysmal nocturnal dyspnoea and bilateral pedal oedema. After extensive investigations, she was diagnosed with hepatic dysfunction, dilated cardiomyopathy (DCM) and coeliac axis thrombosis. Her case was further complicated with episodes of torsades de pointes due to metabolic disturbance, with consequent sudden cardiac arrest. In this case report, we explore the clinical features, pathophysiology and treatment of acute hepatic failure and coeliac axis thrombosis, secondary to DCM and alcoholic liver disease.<\/jats:p>","DOI":"10.1136\/bcr-2023-255332","type":"journal-article","created":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T13:35:20Z","timestamp":1698932120000},"page":"e255332","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Coeliac axis thrombosis and acute hepatic failure in a patient with dilated cardiomyopathy"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3281-5903","authenticated-orcid":false,"given":"Arouba","family":"Imtiaz","sequence":"first","affiliation":[{"name":"Cardiff and Vale University Health Board, Cardiff, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rhys","family":"Morris","sequence":"additional","affiliation":[{"name":"Radiology Registrar, Aneurain Bevan University Health Board, Newport, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Freya","family":"Lodge","sequence":"additional","affiliation":[{"name":"Consultant Cardiologist, Aneurin Bevan University Health Board, Newport, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,11,2]]},"reference":[{"key":"2025082803500229000_16.11.e255332.1","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1097\/HPC.0000000000000229","article-title":"Prevalence and predictors of obstructive coronary artery disease in nonlow-risk acute chest pain patients who rule out for myocardial infarction in the high-sensitivity troponin era","volume":"20","author":"Mahmoud","year":"2021","journal-title":"Crit Pathw Cardiol"},{"key":"2025082803500229000_16.11.e255332.2","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1038\/s41572-019-0084-1","article-title":"Dilated cardiomyopathy","volume":"5","author":"Schultheiss","year":"2019","journal-title":"Nat Rev Dis Primers"},{"key":"2025082803500229000_16.11.e255332.3","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht246"},{"key":"2025082803500229000_16.11.e255332.4","unstructured":"Shah N , Royer A , John S . Acute liver failure. StatPearls 2022. Available: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK482374\/"},{"key":"2025082803500229000_16.11.e255332.5","doi-asserted-by":"crossref","first-page":"18028","DOI":"10.1038\/nrdp.2018.28","article-title":"Pulmonary embolism","volume":"4","author":"Huisman","year":"2018","journal-title":"Nat Rev Dis Primers"},{"key":"2025082803500229000_16.11.e255332.6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2012\/741653","article-title":"Celiac artery thrombosis and superior mesenteric artery stenoses with essential thrombocythemia: a case report","volume":"2012","author":"Keskin","year":"2012","journal-title":"Case Rep Med"},{"key":"2025082803500229000_16.11.e255332.7","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1055\/s-0031-1278334","article-title":"Celiac artery embolism due to thrombophilia \u2013 a case report","volume":"18","author":"Trellopoulos","year":"2009","journal-title":"Int J Angiol"},{"key":"2025082803500229000_16.11.e255332.8","first-page":"62","article-title":"Possible cause underlying gastric necrosis and perforation: celiac artery thrombosis","volume":"1","author":"Peker","year":"2017","journal-title":"J Surg Med"},{"key":"2025082803500229000_16.11.e255332.9","first-page":"273","article-title":"Coeliac artery thrombosis: an uncommon cause of an acute abdomen","volume":"66","author":"Saravana","year":"2011","journal-title":"Med J Malaysia"},{"key":"2025082803500229000_16.11.e255332.10","doi-asserted-by":"crossref","unstructured":"Dooley JS , Lok ASF , Burroughs AK , et al . Sherlock\u2019s Diseases of the Liver and Biliary System. 12th ed. Wiley-Blackwell, 25 April 2011. doi:10.1002\/9781444341294","DOI":"10.1002\/9781444341294"},{"key":"2025082803500229000_16.11.e255332.11","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1055\/s-0038-1642036","article-title":"Pathophysiology, and natural history of pulmonary embolism","volume":"35","author":"Turetz","year":"2018","journal-title":"Semin Intervent Radiol"},{"key":"2025082803500229000_16.11.e255332.12","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.018263"},{"key":"2025082803500229000_16.11.e255332.13","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.mpsur.2018.12.006","article-title":"Mesenteric ischaemia","volume":"37","author":"Evans","year":"2019","journal-title":"Surgery (Oxford)"},{"key":"2025082803500229000_16.11.e255332.14","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1093\/eurheartj\/ehaa1012","article-title":"Heart failure drug treatment: the fantastic four","volume":"42","author":"Bauersachs","year":"2021","journal-title":"Eur Heart J"},{"key":"2025082803500229000_16.11.e255332.15","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab368"},{"key":"2025082803500229000_16.11.e255332.16","doi-asserted-by":"crossref","first-page":"3627","DOI":"10.1093\/eurheartj\/ehad195","article-title":"2023 focused update of the 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"44","author":"McDonagh","year":"2023","journal-title":"Eur Heart J"},{"key":"2025082803500229000_16.11.e255332.17","unstructured":"Agency MaHpR . Spironolactone and renin-angiotensin system drugs in heart failure: risk of potentially fatal hyperkalaemia: Gov.UK. 2016. Available: https:\/\/www.gov.uk\/drug-safety-update\/spironolactone-and-renin-angiotensin-system-drugs-in-heart-failure-risk-of-potentially-fatal-hyperkalaemia"},{"key":"2025082803500229000_16.11.e255332.18","unstructured":"Cohagan B , Brandis D . Torsade de Pointes. StatPearls, 2021. Available: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459388\/"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-255332","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:50:10Z","timestamp":1756378210000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-255332"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11]]},"references-count":18,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,11,2]]},"published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1136\/bcr-2023-255332"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-255332","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11]]}}}