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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Painful, Swollen Ankles. Blood Test Done, ECG Shows Left Axis Deviation, ECHO Shows Impaired LV. Liver Damage?

Sir, My Haemoglobin is 10.58, Bilirubin 1, SGPT 53, SGOT 48.. ECG-Left Axus deviation and Echo doppler test impaired LV dialostic relaxation. I used to drink alchohol but stopped few days back. I am having painful but slighly less swoolen ankles. Am I suffering from the liver damage? What is the stage and can the damage be reversible? And if yes How... Please advice
Mon, 21 Oct 2013
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Psychiatrist 's  Response
Welcome to HCM!
I have gone through your question, from that the things that are bothering you ar slightly elevated liver enzymes, pain and swelling in ankles. But what I find more important is that ECG and ECHO findings, which suggest cardiac cause, most probably due to alcohol raleted cardiomyopathy. But it appears to be in its initial course.

The liver enzymes are not the main concern as liver enzymes are almost fine, they are worrisome if they go more than three four times the normal range, which is not in your case. They should correct themselves as you have stopped alcohol altogether. So, liver appears to be less damaged, may be grade I and reversible. however, an ultrasound abdomen will give a confirming picture of its status.

If I had been your doctor I would go for your Blood pressure recordings, an ultrasound abdomen, and complete renal function test to clarify the status of other organs. I would also like to know your serum proteins level, because some swelling can come in its deficiency too. In such cases some pain can occur with swelling as feet are the weight bearing areas of the body.

From my experience I can say that you should maintain complete abstinence from liquor in any form as long as possible, preferably for life now, this will help your heart the most. You should cut down oil intake and go with a good protenitious diet, which will be helpful.

I hope this answer helps you.
Please feel free to ask more regarding this.
Dr. Manisha Gopal


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Painful, Swollen Ankles. Blood Test Done, ECG Shows Left Axis Deviation, ECHO Shows Impaired LV. Liver Damage?

Welcome to HCM! I have gone through your question, from that the things that are bothering you ar slightly elevated liver enzymes, pain and swelling in ankles. But what I find more important is that ECG and ECHO findings, which suggest cardiac cause, most probably due to alcohol raleted cardiomyopathy. But it appears to be in its initial course. The liver enzymes are not the main concern as liver enzymes are almost fine, they are worrisome if they go more than three four times the normal range, which is not in your case. They should correct themselves as you have stopped alcohol altogether. So, liver appears to be less damaged, may be grade I and reversible. however, an ultrasound abdomen will give a confirming picture of its status. If I had been your doctor I would go for your Blood pressure recordings, an ultrasound abdomen, and complete renal function test to clarify the status of other organs. I would also like to know your serum proteins level, because some swelling can come in its deficiency too. In such cases some pain can occur with swelling as feet are the weight bearing areas of the body. From my experience I can say that you should maintain complete abstinence from liquor in any form as long as possible, preferably for life now, this will help your heart the most. You should cut down oil intake and go with a good protenitious diet, which will be helpful. I hope this answer helps you. Please feel free to ask more regarding this. Dr. Manisha Gopal