ISCHEMIC HEPATITIS IN A PATIENT WITH CONGESTIVE CARDIOMYOPATHY - AN INNOVATIVE APPROACH TO THERAPY USING

Patients who sustain a transient period of hypotension or low cardiac output can develop massive elevations of the serum transaminases witho ut serum markers of acute hepatitis, a recent myocardial infarction or exposure to toxins and chemicals. This condition is often termed ''is chemic hepatitis'' (IH), with its pathological correlate being centril obular necrosis. Recognition of IH can help in the appropriate managem ent of these patients, and avoid unnecessary diagnostic testing. The a uthors describe a patient with congestive cardiomyopathy in whom IH de veloped as part of a complicated hospital course. The condition appear ed to reverse with the administration of dobutamine, suggesting inotro pic therapy as an appropriate treatment modality.