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Related Experiment Videos

"Flipped" lactic dehydrogenase pattern in acute coronary insufficiency.

I Weinberger, Z Rotenberg, A Sagie

    Clinical Cardiology
    |December 1, 1986
    PubMed
    Summary

    Serum lactic dehydrogenase (LDH) isoenzyme testing can detect myocardial damage in acute coronary insufficiency (ACI) patients, even when other cardiac enzymes are normal. A "flipped" LDH pattern indicates damage, aiding diagnosis and treatment decisions.

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    Area of Science:

    • Cardiology
    • Biochemistry

    Background:

    • Acute coronary insufficiency (ACI) diagnosis can be challenging, especially when patients present late.
    • Standard cardiac enzyme tests like creatine kinase-MB may return to normal within 24 hours.

    Observation:

    • Serum lactic dehydrogenase (LDH) isoenzymes were analyzed in 85 ACI patients and 10 stable angina controls.
    • A "flipped" LDH pattern (LDH1 > LDH2) was observed in 15 ACI patients with normal total LDH and creatine kinase-MB levels.

    Findings:

    • The "flipped" LDH pattern, with LDH 1:2 ratios between 1.02-1.13, suggests myocardial damage in ACI patients.
    • Control patients with stable angina showed normal LDH isoenzyme distribution.
    • This pattern may be linked to myocytolysis and coagulation necrosis observed in postmortem studies.

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    Implications:

    • LDH isoenzyme measurement is valuable for diagnosing myocardial damage in ACI, particularly in late presentations.
    • A "flipped" LDH pattern may necessitate longer rest periods and earlier coronary angiography.
    • This diagnostic tool aids in differentiating ACI from stable angina when other markers are normalized.