Acute Shock Liver in Inferior ST-Segment Elevation Myocardial infarct with Total Atrioventricular block: A Case Report
Liver dysfunction frequently accompanies heart diseases, especially in hemodynamically unstable acute heart failure or cardiogenic shock. This condition is marked by significant elevation of liver transaminases and brings high morbidity and mortality for > 50 % of cases. Despite the high mortali...
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Interna Publishing
2025-07-01
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| Series: | Acta Medica Indonesiana |
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| Online Access: | http://www.actamedindones.org/index.php/ijim/article/view/2742 |
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| author | Mochamad Rizky Hendiperdana Sumardjo Sumardjo |
| author_facet | Mochamad Rizky Hendiperdana Sumardjo Sumardjo |
| author_sort | Mochamad Rizky Hendiperdana |
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Liver dysfunction frequently accompanies heart diseases, especially in hemodynamically unstable acute heart failure or cardiogenic shock. This condition is marked by significant elevation of liver transaminases and brings high morbidity and mortality for > 50 % of cases. Despite the high mortality rate, early recognition with prompt management results in the recovery of liver function. A 53-year-old man presented with late-onset non-reperfused inferior STEMI. The patient presented with persistent chest pain and shortness of breath. The electrocardiogram showed atrioventricular (AV) block grade III and ST-segment elevation evolution in the inferior lead. The patient was diagnosed with a late-onset inferior STEMI with cardiogenic shock and total AV block complication, acute shock liver, lactic acidosis, and acute renal failure. We administered inotropic and chronotropic support drugs as well as post-MI anti-remodelling therapy to treat heart failure (HF) and left ventricular (LV) systolic dysfunction, such as angiotensin-converting enzyme inhibitor and aldosterone antagonist, after systemic perfusion improved. Anti-ischemic therapy, such as antithrombotics, was also administered. Renal and liver function test evaluation after a week of patient discharge showed normalization of these parameters. There is no definite treatment strategy for shock liver. The management strategy is directed at the treatment of underlying causes. Hemodynamic insult is the mainstay therapeutic target. Recovery of liver transaminases was demonstrated after the underlying insult had been eliminated.
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| format | Article |
| id | doaj-art-d89b883e1d414b7581363e6725e5d767 |
| institution | Kabale University |
| issn | 0125-9326 2338-2732 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Interna Publishing |
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| series | Acta Medica Indonesiana |
| spelling | doaj-art-d89b883e1d414b7581363e6725e5d7672025-08-20T03:50:00ZengInterna PublishingActa Medica Indonesiana0125-93262338-27322025-07-01572Acute Shock Liver in Inferior ST-Segment Elevation Myocardial infarct with Total Atrioventricular block: A Case ReportMochamad Rizky Hendiperdana0Sumardjo Sumardjo1Department of Cardiology Regional Public Hospital Pandan Arang of Boyolali, IndonesiaGastroenterohepatology division, Department of Internal Medicine Regional Public Hospital Pandan Arang of Boyolali, Indonesia Liver dysfunction frequently accompanies heart diseases, especially in hemodynamically unstable acute heart failure or cardiogenic shock. This condition is marked by significant elevation of liver transaminases and brings high morbidity and mortality for > 50 % of cases. Despite the high mortality rate, early recognition with prompt management results in the recovery of liver function. A 53-year-old man presented with late-onset non-reperfused inferior STEMI. The patient presented with persistent chest pain and shortness of breath. The electrocardiogram showed atrioventricular (AV) block grade III and ST-segment elevation evolution in the inferior lead. The patient was diagnosed with a late-onset inferior STEMI with cardiogenic shock and total AV block complication, acute shock liver, lactic acidosis, and acute renal failure. We administered inotropic and chronotropic support drugs as well as post-MI anti-remodelling therapy to treat heart failure (HF) and left ventricular (LV) systolic dysfunction, such as angiotensin-converting enzyme inhibitor and aldosterone antagonist, after systemic perfusion improved. Anti-ischemic therapy, such as antithrombotics, was also administered. Renal and liver function test evaluation after a week of patient discharge showed normalization of these parameters. There is no definite treatment strategy for shock liver. The management strategy is directed at the treatment of underlying causes. Hemodynamic insult is the mainstay therapeutic target. Recovery of liver transaminases was demonstrated after the underlying insult had been eliminated. http://www.actamedindones.org/index.php/ijim/article/view/2742shock liverhypoxic hepatitiscardiogenic shockmyocardial infarction |
| spellingShingle | Mochamad Rizky Hendiperdana Sumardjo Sumardjo Acute Shock Liver in Inferior ST-Segment Elevation Myocardial infarct with Total Atrioventricular block: A Case Report Acta Medica Indonesiana shock liver hypoxic hepatitis cardiogenic shock myocardial infarction |
| title | Acute Shock Liver in Inferior ST-Segment Elevation Myocardial infarct with Total Atrioventricular block: A Case Report |
| title_full | Acute Shock Liver in Inferior ST-Segment Elevation Myocardial infarct with Total Atrioventricular block: A Case Report |
| title_fullStr | Acute Shock Liver in Inferior ST-Segment Elevation Myocardial infarct with Total Atrioventricular block: A Case Report |
| title_full_unstemmed | Acute Shock Liver in Inferior ST-Segment Elevation Myocardial infarct with Total Atrioventricular block: A Case Report |
| title_short | Acute Shock Liver in Inferior ST-Segment Elevation Myocardial infarct with Total Atrioventricular block: A Case Report |
| title_sort | acute shock liver in inferior st segment elevation myocardial infarct with total atrioventricular block a case report |
| topic | shock liver hypoxic hepatitis cardiogenic shock myocardial infarction |
| url | http://www.actamedindones.org/index.php/ijim/article/view/2742 |
| work_keys_str_mv | AT mochamadrizkyhendiperdana acuteshockliverininferiorstsegmentelevationmyocardialinfarctwithtotalatrioventricularblockacasereport AT sumardjosumardjo acuteshockliverininferiorstsegmentelevationmyocardialinfarctwithtotalatrioventricularblockacasereport |