Document Detail

Cardiac enzymes. How to use serial determinations to confirm acute myocardial infarction.
MedLine Citation:
PMID:  1437917     Owner:  NLM     Status:  MEDLINE    
Although acute myocardial infarction can be diagnosed on the basis of clinical history, electrocardiographic (ECG) findings, and abnormalities of creatine kinase (CK) and lactate dehydrogenase (LDH) enzyme levels, measurement of cardiac enzyme levels is the most reliable way to confirm or exclude the diagnosis. If the MB isoenzyme of creatine kinase (CK-MB) remains normal during the 48 hours after the suspected clinical event, acute myocardial infarction can be reliably ruled out; if CK-MB values become elevated and the LDH isoenzyme pattern (LDH2:LDH1 ratio) becomes "flipped," the diagnosis can reliably be made. However, if CK-MB values become elevated but the LDH isoenzyme pattern remains normal, the diagnosis is less firm and ECG and myocardial imaging techniques may be needed to confirm or exclude myocardial infarction.
R S Ruzich
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Postgraduate medicine     Volume:  92     ISSN:  0032-5481     ISO Abbreviation:  Postgrad Med     Publication Date:  1992 Nov 
Date Detail:
Created Date:  1992-12-17     Completed Date:  1992-12-17     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0401147     Medline TA:  Postgrad Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  85-9, 92     Citation Subset:  AIM; IM    
Mayo Clinic Scottsdale, Scottsdale, AZ 85259.
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MeSH Terms
Creatine Kinase / blood*
Electrocardiography / standards
Electrophoresis / standards
False Positive Reactions
Immunoassay / standards
L-Lactate Dehydrogenase / blood*
Myocardial Infarction / blood*,  diagnosis,  epidemiology
Sensitivity and Specificity
Reg. No./Substance:
0/Isoenzymes; EC Dehydrogenase; EC Kinase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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