Myocardial infarction and effort rhabdomyolysis. Problems caused by serum enzymatic assays]

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