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Related Concept Videos

Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Myocarditis III: Medical Management01:14

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Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
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Acute Coronary Syndrome I: Introduction01:30

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Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
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Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

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The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
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Myocarditis II: Clinical Features and Diagnostic Tests01:27

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Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
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Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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High AST/ALT Ratio Is Associated with Cardiac Involvement in Acute COVID-19 Patients.

Mesut Karatas1, Nursen Keles2, Kemal Emrecan Parsova3

  • 1Department of Cardiology, Kartal Kosuyolu Yuksek Ihtisas Training and Research Hospital, University of Health Sciences, Istanbul 34865, Turkey.

Medicina (Kaunas, Lithuania)
|June 28, 2023
PubMed
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A high aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio in recovered COVID-19 patients indicates impaired cardiac function. This ratio may help identify individuals at risk for cardiac involvement, necessitating closer monitoring.

Keywords:
AST/ALT ratioCOVID 19De Ritis ratiocardiac imagingcardiac magnetic resonance imagingspeckle tracking echocardiography

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Area of Science:

  • Cardiology
  • Infectious Diseases
  • Biochemistry

Background:

  • COVID-19 can lead to cardiac complications even after recovery.
  • The AST/ALT ratio is a marker of liver function and inflammation.
  • Its role in post-COVID cardiac sequelae requires further investigation.

Purpose of the Study:

  • To evaluate the association between the AST/ALT ratio and cardiac parameters in recovered COVID-19 patients.
  • To determine if the AST/ALT ratio can predict cardiac involvement post-COVID-19.

Main Methods:

  • 87 hospitalized COVID-19 patients (non-ICU) were studied post-recovery.
  • Patients were divided into high and low AST/ALT ratio subgroups based on the median value.
  • Cardiac function was assessed using transthoracic echocardiography (TTE) and cardiac magnetic resonance imaging (CMRI).

Main Results:

  • Higher AST/ALT ratio correlated with elevated inflammatory markers (CRP, D-dimer, fibrinogen).
  • Impaired left and right ventricular function (lower LVEF, TAPSE, S', FAC, RV stroke volume, RV ejection fraction; higher RV end-systolic volume) observed in high AST/ALT group.
  • Increased myocardial T1/T2 mapping signals and extracellular volume detected by CMRI in high AST/ALT group.

Conclusions:

  • An elevated AST/ALT ratio is linked to echocardiographic and CMRI-defined cardiac dysfunction after COVID-19 recovery.
  • AST/ALT ratio at admission may serve as a risk indicator for cardiac involvement in COVID-19.
  • Patients with high AST/ALT ratios may benefit from intensified cardiac monitoring.