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Ischemic Hepatitis in a Patient with Congestive Cardiomyopathy: An Innovative Approach to Therapy Using Intravenous Dobutamine
Author(s) -
Levy Daniel K.,
Schwartz Jonathan M.,
Frishman William H.,
Schwarz Michael L.,
LeJemtel Thierry H.
Publication year - 1994
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1002/j.1552-4604.1994.tb03998.x
Subject(s) - medicine , dobutamine , inotrope , heart failure , ischemic cardiomyopathy , cardiology , myocardial infarction , cardiomyopathy , anesthesia , intensive care medicine , hemodynamics , ejection fraction
Patients who sustain a transient period of hypotension or low cardiac output can develop massive elevations of the serum transaminases without serum markers of acute hepatitis, a recent myocardial infarction or exposure to toxins and chemicals. This condition is often termed “ischemic hepatitis” (IH), with its pathological correlate being centrilobular necrosis. Recognition of IH can help in the appropriate management of these patients, and avoid unnecessary diagnostic testing. The authors describe a patient with congestive cardiomyopathy in whom IH developed as part of a complicated hospital course. The condition appeared to reverse with the administration of dobutamine, suggesting inotropic therapy as an appropriate treatment modality.