A CASE OF HIGH TRANSAMINASES DUE TO CARDI AC CONGESTIVE FAILURE MIMICKING CHRONIC HEPATITIS

We report the case of a young man first seen by is in 1989 at the age of 20 years. The diagnoses of hypertrophic cardiomyopathy, Wolf-Parkin son-White syndrome, congestive heart failure and pulmonary hypertensio n were made. One month later the patient had jaundice and hepatomegaly and a diagnosis of acute viral hepatitis A was established by laborat ory findings. The ALT and AST levels were persistently elevated, seven times the normal mean, during six years. Two liver biopsies in 1991 a nd 1993 showed liver injury secondary to congestive heart failure (CHF ) as the only abnormality. This case illustrates the importance of liv er injury secondary to CHF as a cause of a marked and persistent incre ase of ALT and AST that resembles that of other liver diseases.