1 Department of Cardiology, Children's Hospital, 300 Longwood Avenue, Boston, Massachusetts 02115
2 Pediatric Associates of Fall River, Inc., 300 Hanover Street, Fall River, Massachusetts 02721-5444
In Reply.
Dr Choi has raised the very important issue of interpretation of electrocardiographic and serum enzyme changes. We agree entirely that these findings are not definitive, that is, diagnostic of ischemia. As we carefully stated, they are "consistent with" myocardial ischemia. Interpretation of these results, as with virtually any laboratory result, depends on the clinical setting and the probability of the various possibilities. As noted, elevation of creatine kinase (CK) activity can occur in a number of situations including vigorous exercise.