Cardiac Ascites: What Causes It?


Most symptoms correspond to a particular illness and these can actually be helpful for patients and healthcare professionals. This is because such symptoms can aid in the earlier detection and management of certain health conditions or illnesses. One common symptom of liver cirrhosis is ascites but it can also be a symptom of other health conditions. With this, some patients may be asking, what can be causing ascites? Can it also be a symptom of something related to heart health? For this article, we answer these questions about ascites and its link to cardiovascular health. Read on to find out more!

Ascites: A General Overview

Ascites is medically defined as fluid accumulation that is abnormal and is usually found in the cavity of the peritoneum. This condition can be due to a number of different diseases or health reasons such as tuberculosis, cancer of the liver, and liver scarring or cirrhosis. However, ascites are more commonly associated or linked to liver cirrhosis and some of the signs and symptoms of the said medical condition include failure of the liver, shortness of breath, bloating, and pain in the abdomen.

Cardiac Ascites: What are they?

As mentioned earlier, ascites are commonly associated with cirrhosis of the liver. However, they may also be the result of other health conditions such as congestive heart failure. Cardiac ascites are the result of such a medical condition as it can lead to a pressure gradient that is increased and can lead to fluid retention in the body that is generalized. In laboratory tests, cardiac ascites are commonly identified with ascitic fluid with levels of protein at 2.5 g/dL or higher and a SAAG measuring 11 g/L or 1.1 g/dL. Once both these numbers are observed, then the ascites are most probably caused by heart conditions and are therefore cardiac ascites.

Those with cardiac ascites will usually have the treatment that will address heart failures such as dietary restrictions and medical management. Other treatment options may include the placing of a shunt to remove portal pressure in the veins of the heart that return blood to the organ itself. The good news is that patients with cardiac ascites caused by heart failure can have a more positive outcome than other patients with ascites as there is data to suggest that the said patients can live for many years as long as treatments are regularly received.

Ascites: Some of the Possible Causes of Ascites

One of the most common illnesses that can lead to ascites is cirrhosis or liver disease. While the mechanism for the development of ascites is not yet fully understood, most experts believe that portal hypertension (increased blood pressure flow into the liver) is the major culprit. The same basic principle applies when edema is formed as it is also caused by pressure imbalance in the circulation inside (a system that is high pressure) and the abdominal cavity (outside) (space that is low pressure). The reduction in blood pressure of the portal and albumin decrease (a form of blood transported protein) may be the major contributing factor in the formation of the said pressure imbalance leading to the development of ascites in the abdomen.

Water And Salt Retention

Some of the other possible causes of ascites are the retention of water and salt. The volume of blood circulating may be construed as low by the kidney’s “sensors” as ascites formation can lead to the depletion of the volume of water and salt in the blood. This can then send a signal to the kidneys to reabsorb more water and salt in an attempt to compensate for the said loss in volume.

Other Health Conditions

Ascites may also be caused by some other factors such as failure of the kidney and congestive heart failure. Some other rare cases may include the increase in portal pressure or portal hypertension. Some of these can include a tumor or a mass that can put pressure on the portal vessels from inside the cavity of the abdomen. It can also be due to the formation of a blood clot in the portal vessel that can lead to the obstruction of regular blood flow and elevate vessel pressure. An example of such a disease is known as Budd-Chiari Syndrome.


These ascites can also be due to malignant ascites which are classified as a form of cancer. This class of ascites can be a form of cancers of different organs that are considered advanced and will usually be found in the cavity of the abdomen. These include cancers such as ovarian cancer, lung cancer, lymphoma, breast cancer, stomach cancer, pancreatic cancer, and colon cancer.


Those with pancreatitis that are long-standing (also known as chronic pancreatitis) can also experience ascites formation due to the pancreas’ inflammation. Prolonged abuse and consumption of alcohol are some of the most common factors that can lead to chronic pancreatitis. Pancreatic ascites may also be caused by trauma to the pancreas or by acute pancreatitis.

Ascites Risk Factors

Most of the risk factors for cirrhosis and the development of ascites are common to each other and are quite similar. Some of these factors that are common are alcohol abuse that is long-standing, hepatitis C, and hepatitis B. Other risk factors for the formation of ascites include other related health conditions such as kidney disease, malignancy, and congestive heart failure.

Common Ascites Symptoms

The symptoms of ascites may not be easily felt or detected . However, as the fluid accumulation progresses, an increase in the girth and size of the abdomen is observed. Bloating, discomfort, and pain in the abdomen can also be experienced by the patient. Large ascites can also bring about shortness of breath due to diaphragm pressure caused by fluid migration and the resulting pleural effusions (formation of fluids in the area surrounding the lungs). Patients also have a cosmetic concern caused by ascites which is a disfigured looking belly as a result of fluid buildup and accumulation.

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