Acute Shock Liver in Inferior ST-Segment Elevation Myocardial infarct with Total Atrioventricular block: A Case...

Area of Science:

• Cardiology
• Hepatology
• Critical Care Medicine

Background:

• Liver dysfunction is common in heart disease, particularly acute heart failure and cardiogenic shock.
• This condition, characterized by elevated liver enzymes, has high morbidity and mortality rates.
• Early recognition and prompt management are crucial for liver function recovery.

Purpose of the Study:

• To present a case of cardiogenic shock and acute liver dysfunction secondary to ST-elevation myocardial infarction (STEMI).
• To highlight the importance of addressing the underlying hemodynamic insult in managing shock liver.
• To demonstrate the potential for liver function recovery with appropriate treatment.

Main Methods:

• A 53-year-old male patient with inferior STEMI, cardiogenic shock, and complete atrioventricular block was treated.
• Management included inotropic and chronotropic support, post-MI anti-remodeling therapy, and anti-ischemic treatment.
• Hemodynamic stability was prioritized to improve systemic perfusion.

Main Results:

• The patient presented with STEMI, cardiogenic shock, complete AV block, acute shock liver, lactic acidosis, and acute renal failure.
• Following treatment aimed at improving hemodynamic status and addressing the underlying cardiac event, liver and renal functions normalized within a week post-discharge.
• Recovery of liver transaminases was observed after the elimination of the hemodynamic insult.

Conclusions:

• Shock liver management focuses on treating the underlying cause, primarily hemodynamic instability.
• Effective treatment of cardiogenic shock can lead to the recovery of liver function.
• This case underscores the link between cardiac events, hemodynamic compromise, and secondary liver dysfunction.