In what condition can AST levels also be markedly elevated beside AMI?

Aspartate aminotransferase (AST) is an enzyme that can be elevated in various conditions, not just in the context of acute myocardial infarction (AMI). One such condition where AST levels can also be markedly elevated is in cases of pulmonary embolism.

In the context of pulmonary embolism, the sudden obstruction of a pulmonary artery can lead to acute strain on the right side of the heart. This can result in right ventricular overload and sometimes right heart failure, leading to the release of AST from the damaged myocytes. The elevation of AST in this situation is reflective of cellular damage much like that which occurs during AMI.

While the other conditions presented—cholecystitis, gallstones, and appendicitis—may also affect liver function or lead to inflammation, they typically do not cause the same significant elevation in AST as seen in cases of pulmonary embolism. Cholecystitis and gallstones predominantly involve biliary obstruction, leading to the elevation of enzymes such as alkaline phosphatase or bilirubin, rather than AST specifically. Appendicitis may lead to some increase in AST, but it is not as pronounced and is usually overshadowed by other markers of inflammation and infection.

Understanding the various contexts in which AST