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Approach to screening for esophageal varices and preventing variceal bleeding in adults with cirrhosis

Approach to screening for esophageal varices and preventing variceal bleeding in adults with cirrhosis
This algorithm summarizes the general approach to screening for esophageal varices and preventing variceal bleeding in adults with cirrhosis. This algorithm is intended for use in conjunction with other UpToDate content. Refer to UpToDate's topic on prevention of variceal bleeding for additional details, including the evidence supporting the efficacy of these preventive strategies.

SBP: systolic blood pressure; MAP: mean arterial pressure.

* Patients with cirrhosis and active liver disease include those with ongoing liver inflammation (eg, untreated viral hepatitis, active alcohol use disorder, metabolic syndrome).

ΒΆ The goal resting heart rate for patients on nonselective beta blocker therapy is 55 to 60 beats per minute, provided that MAP remains >82 mmHg. We continue the beta blocker indefinitely while monitoring for adverse effects (eg, hypotension).
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