A 76-year-old woman presented with long-standing anasarca. History included chronic ischemic cardiomyopathy with coronary artery bypass (LIMA–LAD), surgical bioprosthetic replacement of severe aortic stenosis and arterial hypertension. Blood tests and abdominal imaging showed liver cirrhosis with marked hypoalbuminemia. Viral, autoimmune, metabolic and alcohol-related causes were excluded, suggesting cardiac cirrhosis….