Congestive hepatopathy (nutmeg liver), is a liver dysfunction due to venous congestion, usually due to congestive heart failure. The gross pathological appearance of a liver affected by passive congestion is 'speckled' like a grated nutmeg kernel; the dark spots represent the dilated and congested hepatic venules and small hepatic veins. The paler areas are unaffected surrounding liver tissue. The actual size can be determined with the rule below.