A macroscopic hepatic change known as nutmeg liver is indicative of ?

Chronic hea failure results in blood stasis in the central veins and central sinusoids of hepatic lobules, with subsequent central hemorrhagic necrosis. Thus, the red central regions compared with the surrounding tan-brown ble parenchymal impa the mottled appearance of a nutmeg to the liver cut surface. Acute left-sided hea failure gives rise to acute pulmonary edema, with extravasation of plasma and red blood cells into alveolar spaces. Acute right-sided hea failure leads to acute congestion of the liver, which does not acquire the typical nutmeg appearance as in chronic congestion. Alcohol toxicity leads to a number of hepatic alterations. Fatty change results from alteration in lipoprotein metabolism, leading to accumulation of fats as a large single droplet within the cytoplasm of hepatocytes (microvesicular steatosis). Alcoholic hepatitis is an acute response to alcohol abuse and is associated with hepatocyte necrosis and formation of Mallory bodies. Long-standing alcohol toxicity may cause a peurbation of the liver architecture leading to liver cirrhosis. Ref: Mohrman D.E., Heller L.J. (2010). Chapter 11. Cardiovascular Function in Pathological Situations. In D.E. Mohrman, L.J. Heller (Eds), Cardiovascular Physiology, 7e.