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ARTICLE |

Optimal Use of Serum Enzyme Levels in the Diagnosis of Acute Myocardial Infarction:  The Perspective in 1980

Galen S. Wagner, MD
Arch Intern Med. 1980;140(3):317-319. doi:10.1001/archinte.1980.00330150031012.
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The two clinical studies of the importance of the MB isoenzyme of creatine kinase (CK) presented in this issue of the Archives (see pp 329 and 336) provide important and complementary insights into the current status of the diagnosis of acute myocardial infarction. The ECG remains a most important method for the identification of acute myocardial infarction because of a specificity of new QRS changes accompanied by evolutionary ST segment and T wave changes that approaches 100%. However, the QRS complex is the only aspect of the ECG that should be considered diagnostic, because all variations or changes in repolarization manifested either by elevations or depressions of the ST segment or by inversions of the T wave are, like the history of the classical initial symptoms, indications of acute coronary insufficiency either with or without myocardial necrosis. The QRS complex is a very sensitive indicator of new infarction if it

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