Plasma MB creatine kinase activity and other conventional enzymes. Comparison in patients with chest pain and tachyarrhythmias

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Abstract
Patients (67) with tachycardia and chest pain admitted with suspected myocardial infarction were studied; 29 had myocardial infarction (20 transmural, 9 subendocardial) with elevated MB creatine kinase (CK) activity, and elevated total CK and lactate dehydrogenase (LDH) levels. Hydroxybutyric dehydrogenase and serum glutamic oxaloacetic transaminase [SGOT] activity remained normal in 3 and 4 patients, respectively. Despite abnormal ECG in 84% and typical chest pain in 54%, 38 patients had normal MB CK activity. Fifteen had elevated MM CK levels due to release from skeletal muscle. Patients (29) had elevated activity of MM CK, LDH or SGOT, but 72% of these patients had cardiac failure, hypotension or skeletal muscle trauma due to cardioversion. Patients (11) with normal MB CK had elevated hydroxybutyric dehydrogenase activity. Despite elevated activity of other enzymes, MB CK remained normal. Elevated plasma MB CK activity appears to remain a good diagnostic marker of myocardial necrosis in patients with tachyarrhythmias.