SERUM GLUTAMIC-OXALACETIC TRANSAMINASE ACTIVITY IN CONDITIONS ASSOCIATED WITH MYOCARDIAL INFARCTION. II. CEREBRAL VASCULAR ACCIDENTS AND CONGESTIVE HEART FAILURE

Abstract

Since an apparent cerebral vascular accident may be the presenting and sometimes the only symptom of a coronary occlusion, the effect that a cerebral vascular accident might have on SGO-T activity was studied in 21 patients. The patients studied had a diagnosis of recent cerebral vascular accident of varying severity. Electrocardiograms and SGO-T were determined periodically. Nine (43%) of the patients studied showed significant elevation of SGO-T activity (48 - 100 units) with no evidence of cardiac involvement. SGO-T elevation occurred most frequently in cases of severe cerebral vascular accident with curves resembling those of myocardial infarction except for a more gradual initial rise in activity. It appears that the SGO-T activity determination is of limited value in the diagnosis of myocardial infarction when the picture suggests a severe, primary cerebral vascular accident. The evaluation of the effect of acute hepatic congestion on SGO-T levels was studied in 14 patients in moderate to severe right heart failure. Eleven of these patients showed no elevation of SGO-T activity, although 3 of these patients did demonstrate a gradual drop of over 15 units in their "normal" levels with the attainment of compensation. Three patients with unexplained elevations of SGO-T were encountered. It was concluded that the presence of right heart failure does not ordinarily interfere with the interpretation of the SGO-T test in individuals with possible myocardial infarction.