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Beach Conger, MD
Mount Ascutney Hospital and Health Center Windsor, Vt

JAMA. 1984;251(17):2207.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

In their article, "Failure to Diagnose Acute Myocardial Infarction," Zarling et al conclude, on the basis of the fact that there was a marked difference in diagnostic accuracy between those patients who had typical clinical findings of a myocardial infarction with confirmatory laboratory data and those who had similar clinical presentation but no laboratory confirmation, that physicians are dependent on "technical aids" for detection of a myocardial infarction. Unfortunately, their definitions create two groups which, a priori, are biased toward increasing the diagnostic accuracy in class I and decreasing it in class II. It is difficult to miss myocardial infarction when both the clinical and laboratory data agree. Similarly, it is not easy to establish the correct diagnosis when the clinical picture is suspicious but laboratory data are normal or missing.

Since elevation of creatine kinase (CK), and CK-MB levels has become the gold standard for diagnosis . . . [Full Text PDF of this Article]

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