IV rudg aebus + R etahr fiaelur sympomst gescteodn( vei:r)l hnikt iprsctdiu ycfuciniseifn
tgo seocfnud yb eth oltsyisc tplosiaun fo hte rliev btu lycasilba gtugnterari bdool mrof VR llwi go inot AR g&;t VIC g&;t hipaect vnesi
according to B&B, a "pulsatile liver" is a classic finding in severe right HF because the tricuspid regurgitation is transmitted to the abdomen.
I was between tricuspid problems or cirrhosis from hep C. I think if all they give you is a bounding liver go for the valvular problem because cirrhosis would have more symptoms like increased estrogen. I also think the problem being so acute also points to a cardiac origin. Reading the question again, portosystemic shunt isn't so much a diagnosis as a sequelae. I could imagine tricuspid insufficiency eventually causing shunt, but that's not really the underlying diagnosis.