Cardiac enzymes

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Cardiac enzyme levels are more sensitive and specific in confirming or excluding the diagnosis of acute myocardial infarction than are historical or electrocardiographic criteria. Several enzymes are elevated after infarction, but total creatine kinase, the MB isoenzyme of creatine kinase, and lactate dehydrogenase are the most useful. Dr Ruzich explains how serial determinations and attention to appearance, peak, and disappearance times of these enzymes help identify elevation that is unrelated to infarction.