MYOCARDIAL-INFARCTION AND RHABDOMYOLYSIS OF EFFORT - PROBLEMS POSED BY SERUM ENZYME CHANGES

The authors report the case of a patient who presented with myocardial infarction and rhabdomyolysis. The mild ECG changes in the basal lead s and the normal MB creatinine phosphokinase fraction, expressed as a percentage of total CPK, delayed the diagnosis of myocardial infarctio n. The presence of a rhabdomyolysis without any clinical manifestation was suspected from the severe and prolonged increase in cardiac enzym e levels. Contrary to the usual method of measuring the MB fraction of CPK by immuno-inhibition, the fluorimetric immunoenzymological techni que enabled diagnosis of the infero-lateral-basal infarct, later confi rmed by echocardiography and left ventriculography. This new technique would seem to be very useful, given the high sensitivity and specific ity and its rapidity not only in the context of myocardial infarction associated with rhabdomyolysis, but also in the frontier forms of unst able angina and definitive myocardial infarction.