The significance of myoglobin determination in the differential diagnosis of chest pain syndrome

: In 1984-88 the authors examined in 813 subjects with the chest pain syndrome of varying aetiology (acute myocardial infarction, myocarditis, pericarditis, vertebrogenic algic syndrome, embolism of the pulmonary artery, patients lacking detectable organic causes of pain) the trend of myoglobin serum levels. They found significantly elevated values only in patients with myocardial infarction and myocarditis whereby the two diseases differ in particular as regards the shape of the curve of myoglobin values. In chest pain with another aetiology the myoglobin levels rose only rarely or not at all. From the differential diagnostic aspect it is particularly valuable that myoglobin was not elevated in any patient with embolism of the pulmonary artery and only very rarely in angina pectoris. Where in exceptional instances the myoglobin levels were elevated in patients with other investigated causes of chest pain, this increase was always due to another basic disease (right-sided cardiac failure, renal insufficiency, neuromuscular disease), whereby for these conditions prolonged persistence of the elevated serum myoglobin values was typical and the levels were never above 8 nmol/l.