Use of cardiac enzymes in the evaluation of acute chest pain

Ann Emerg Med. 1986 Mar;15(3):354-60. doi: 10.1016/s0196-0644(86)80584-4.


Diagnosis of acute myocardial infarction (AMI) rests upon detailed clinical evaluation of the patient, careful examination of the ECG, and utilization of cardiac enzymes only in those patients admitted to rule out this diagnosis. Any tendency by physicians to diminish emphasis on either of these first two diagnostic criteria, or to inappropriately utilize cardiac enzymes as a screening device, contributes to costly and inefficient errors in diagnosis and disposition of patients with chest pain. Utilization of recently developed mathematical models may prove effective in enhancing clinical judgment and presenting such errors.

Publication types

  • Review

MeSH terms

  • Aspartate Aminotransferases / analysis
  • Creatine Kinase / analysis
  • Diagnosis, Differential
  • Electrocardiography
  • Electrophoresis
  • Emergencies*
  • False Negative Reactions
  • False Positive Reactions
  • Humans
  • Isoenzymes / analysis
  • L-Lactate Dehydrogenase / blood
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / enzymology
  • Pain


  • Isoenzymes
  • L-Lactate Dehydrogenase
  • Aspartate Aminotransferases
  • Creatine Kinase