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Letters |2 December 2003

Coronary Artery Disease and the Acute Coronary Syndrome

Tony J. DeMartini, MD; Henry S. Loeb, MD

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  • From Hines Veterans Affairs Hospital, Hines, IL 60141.
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TO THE EDITOR:
Background: Coronary artery disease and the acute coronary syndrome are difficult to identify in patients with an atypical history. A complete history and physical examination, in addition to electrocardiography and measurement of serum cardiac enzymes, contribute to the accurate diagnosis of the disease.
Cardiac enzymes used to identify myocardial damage have undergone an extensive transformation. In 1954, Karmen and colleagues used serum glutamic oxaloacetic aminotransferase and lactate dehydrogenase (LDH) as markers of myocardial infarction (1). Reliance on these enzymes is problematic because of low sensitivity and specificity. The sensitivity and specificity of the LDH isoenzymes increased...
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DeMartini TJ, Loeb HS. Coronary Artery Disease and the Acute Coronary Syndrome. Ann Intern Med. 2003;139:W–82. doi: https://doi.org/10.7326/0003-4819-139-11-200312020-00022-w1

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Published: Ann Intern Med. 2003;139(11):W-82.

DOI: 10.7326/0003-4819-139-11-200312020-00022-w1

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2003 American College of Physicians
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