Presentation
Shortness of breath and chest pain with a history of alcohol use.
Patient Data
Velocities of sound transmission:
Mean: 1.79 m/s
Median: 1.78 m/s
Velocity interquartile range: 0.21 m/s
Velocity interquartile range/median: 11.7%, representing reliable values.
Impression: abnormal liver stiffness compatible with advanced fibrosis (F3 METAVIR score).
Case Discussion
This represents a case of advanced hepatic fibrosis. Our patient presented to the emergency department complaining of a 2-day history of difficulty breathing that had gotten worse. With a medical history of multiple comorbidities (essential hypertension, diabetes, ischemic cardiomyopathy, coronary artery disease, and alcohol use disorder), a part of his diagnostic work-up included a liver ultrasound, which revealed fibrosis.
Ultrasound elastography on equipment estimates hepatic fibrosis stages as:
normal/F1 METAVIR score: 1.35–1.66 m/s (5.48 kPa–8.29 kPa)
significant fibrosis/F2 METAVIR score: 1.66–1.77 m/s (8.29 kPa–9.40 kPa)
advanced fibrosis/F3 METAVIR score: 1.77–1.99 m/s (9.40 kPa–11.9 kPa)
cirrhosis/F4 METAVIR score: >1.99 m/s (>11.9 kPa)
Unable to process the form. Check for errors and try again.