New England Journal of Medicine Publishes Images on Liver Condition Linked to Heart Valve Problem

The NEJM has shared clinical images showing a pulsating liver (pulsatile liver) in a patient with severe tricuspid regurgitation, a condition where the heart’s right-side valve leaks blood backwards.

The New England Journal of Medicine posted the case to its X account, flagging it under the #Cardiology hashtag. The images form part of the journal’s ongoing Images in Clinical Medicine series, which presents rare or instructive findings from real patient cases to medical professionals worldwide.

Tricuspid regurgitation is a heart valve disorder in which the tricuspid valve — the valve between the right upper and lower chambers of the heart — fails to close properly, allowing blood to flow back the wrong way. In severe cases, according to the NHS, this backwards pressure can affect other organs, including the liver, causing it to swell and, in some instances, to pulse visibly in time with the heartbeat.

A pulsatile liver — one that beats or throbs — is an uncommon clinical sign. It points to significant strain on the right side of the heart and is considered a marker of advanced disease.

The NEJM is one of the world’s most widely read medical journals and its Images in Clinical Medicine series is aimed at clinicians rather than the general public. The post does not relate to a specific Kent patient or local service change.

Anyone in Kent who has been told they have a heart valve condition, or who experiences symptoms such as breathlessness, swollen ankles, or a swollen abdomen, should speak to their GP. For urgent concerns, NHS 111 is available around the clock by phone or online.