Abnormal LFT

[Didda]

Went to the doctor for a physical after experiencing severe shortness of breath at nights, fatigue and dizziness.  I workout regularly and am very active.  Weight is normal though I am slightly muscular.  I am a 41 year old African-American Male.  I had elevated AST-84 (normal to 45), ALT-46 (normal to 45) and creatinine level-1.8 (normal to 1.5) in August this year.  Tests were repeated in September and ALT was in normal range but AST was still high (50).  Creatinine was down to 1.4.  All other tests normal and negative for Hepatitis.  However Prothrombin time is high-11.7 (normal to 11.5).  INR was at the maximum for normal range (1.1).  All ultrasounds were normal for liver and abdominal though Kidney ultrasound showed increased proximal renal artery velocities at 43cm/sec on right and 58 on left compared to normal low range of 63 cm/sec.  Heart showed mild leaks on right valves and mild leak on one left valve.  
Liver Biopsy performed in early October.  Findings were minimal Zone 3 sinusoidal dilatation with atrophy of adjacent hepatocytes with possible hepatic venous outflow obstruction with possible relation to congestive heart failure.  What does all of this mean and what should be my next steps.  IS it okay for me to continue aerobics (I run approximately 20 miles per week) and lift weights.  I continue to experience fatigue, dizziness and shortness of breath.

[revo39564]

Hello



Have you ever been diagnosed or treated for hypertension,anemia,diabetes,or depression/anxiety? Also, do you take any herbal or sports supplements

[Kevin Pho, MD]

The liver biopsy suggests that there may be some damage secondary to congestive heart failure.  If you think of the heart as a pump, and for some reason it isn't working well (i.e. in congestive heart failure), the subsequent backup can affect the liver.  

Next steps would be to evaluate the heart - which can certainly cause shortness of breath.  An echocardiogram would be the appropriate test.  

Regarding aerobics and weights, I would discuss this with your personal physician to ensure it is safe if there is presence of any heart condition.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[Didda]

I have not yet been to a cardiologist.  These tests began with visit to my primary followed by a referral to a GI specialist because of the elevated liver enzymes.  The valves had mild leaks which I am to understand are a little more advanced than trace leaks but I am scheduling a follow-up witha cardiologist.  My biggest concern is that my mother was diagnosed with Congestive Heart failure more than a year ago and I am also concerned about the higher prevalence with this condition among African-Americans and males.  Thanks so much for your concern and advice.

[dartmouth03]

sorry to hear about the health problems...you mentioned heart failure - have you seen a cardiologist and had an echocardiogram?  you said you had some trivial leakage in the valves (which is normal), so that would mean you had an echo which would show your ejection fraction.  i'm sure if you had "heart failure", your ejection fraction would be low and the cardiologist would let you know...have you had that test, and what did he say?