Myocarditis and myocardial infarction share clinical similarity and daily diagnostic dilemmas. The recommended diagnostic tools today are cardiac MRI or myocardial biopsy. However, various medical centers have difficulty implementing this recommendation due to the unavailability of CMRIs or the risk of myocardial biopsy. Most often, these patients undergo diagnostic catheterization to rule out coronary disease. The need for a quick, non-invasive and inexpensive test to discriminate the two disease is essential. We provide a unique discriminating pattern of serum markers curve in acute. Myocarditis and acute Non-ST myocardial infarction during acute phase. In acute myocarditis troponin progress moderately while CPK progress steeply, both to higher peak, resulting in lower troponin to CPK ratio in the first 48 hours of admission.
Heart Institute, Emek Medical Center, Afula, Israel and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
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