A crucial step in confirming or ruling out the diagnosis ofacute myocardial infarction is the measurement of myocardialenzymes in the serum. The levels of creatine kinase (CK) andespecially of CK-MB (the myocardial-specific isoform) have servedas essential components of decision making in emergency roomsfor over 25 years. Common experience indicates, however, thatthis standard diagnostic test is far from perfect. The diagnosticspecificity of elevations of CK-MB is reduced in the case ofskeletal-muscle injury, such as may occur after chest compressionsfor resuscitation, electrical defibrillation, intramuscularinjections, or extreme exercise. In the critical first six . . . [Full Text of this Article]
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