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July 18, 1966


JAMA. 1966;197(3):216. doi:10.1001/jama.1966.03110030110040

Postmortemfarction in patients who die within a few hours of the onset of myocardial ischemia continues to be difficult for the pathologist. Morphologic changes are not detectable with ordinary histologic strains in the first 6 hours of infarction, and the pathologic changes are somewhat equivocal until the inflammatory infiltrate appears in the infarction of about 12 hours' duration.1 In clinically suspected cases of early infarction, the pathologist is frustrated not only by this difficulty but also by the infrequent finding of coronary artery thrombosis. The cause of death is often listed as arteriosclerotic heart disease, and it is consequently assumed that the patient has died of a "heart attack," which becomes a "diagnosis of exclusion" in such cases. It is desirable, therefore, to find a more sensitive method for detecting early myocardial infarction.

Measuring elevation of serum enzymes released from damaged tissue is valuable in the clinical diagnosis and

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