Origin of Elevated Serum Enzyme Activities after Direct-Current Countershock

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Abstract
Serum creatine kinase (CPK) activity was abnormally elevated on eight of 37 occasions in patients treated with direct-current electroshock. Serum total LDH rose on five and GOT on three occasions. The myocardium was excluded as the enzyme-releasing tissue, since the serum LDH1 isoenzyme decreased after the shock whereas the LDH5 isoenzyme increased in all the cases in which serum CPK activity was elevated. Liver damage was excluded on the basis of normal serum ornithine carbamoyltransferase, γ-glutamyltranspeptidase, alanine aminotransferase and guanase determinations. Measurement of LDH3 and LDH2 isoenzymes did not indicate injury of lung parenchyma. Thus, skeletal muscles appear to be the origin of the enzyme elevations after electroconversion.