Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (863 page)

BOOK: Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis
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   Cardiac contusion.
   After thoracic/open heart surgery, values return to baseline in 24–48 hours. AMI is difficult to diagnose in the first 24 postoperative hours.
   Resuscitation for cardiac arrest may increase CK and CK-MB in approximately 50% of patients, with peak at 24 hours, due to defibrillation (>400 J) and chest compression, but CK-MB/CK total ratio may not be increased, even with AMI.
   Percutaneous transluminal coronary angioplasty.
   Myocarditis.
   Prolonged supraventricular tachycardia.
   Cardiomyopathies (e.g., hypothyroid, alcohol).
   Collagen diseases involving the myocardium.
   Coronary angiography (transient).
   Necrosis, inflammation, or acute atrophy of striated muscle:
   Exercise myopathy; slight to significant increases in 14–100% of persons after extreme exercise (e.g., marathons); smaller increases in wellconditioned athletes
   Skeletal muscle trauma with rhabdomyolysis, myoglobinuria
   Skeletal muscle diseases (e.g., myositis, muscular dystrophies, polymyositis, collagen vascular diseases [especially SLE])

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