Patients with esophageal varices would reveal the following assessment:
A. Increased blood pressure
B. Increased heart rate
C. Decreased respiratory rate
D. Increased urinary output
Correct Answer: B. Increased heart rate
Tachycardia is an early sign of compensation for patients with esophageal varices. Since the portal venous system has no valves, resistance at any level between the splanchnic vessels and the right side of the heart results in retrograde flow and elevated pressure. The collaterals slowly enlarge and connect the systemic circulation to the portal venous system.
Option A: Esophageal varices are a direct result of high blood pressure in the portal vein. This condition is called portal hypertension. It causes blood to build up in nearby blood vessels, including those in your esophagus. Veins begin to dilate and swell as a result of increased blood flow.
Option C: The respiratory rate is not decreased in esophageal varices. Esophageal varices are the major complication of portal hypertension. It is detected in about 50% of cirrhosis patients, and approximately 5–15% of cirrhosis patients show newly formed varices or worsening of varices each year.
Option D: Effective resuscitation, accurate diagnosis, and early treatment are key to reducing mortality in variceal bleeding. The aims are not only to stop bleeding as soon as possible but also to prevent early re-bleeding. Early rebleeding, as with peptic ulcer disease, is significantly associated with worsening mortality.
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