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When a patient has chest pain and a myocardial infarction is suspected, the cardiac enzymes are ordered serially, because the levels of the various components will change with time if there was damage to the heart muscle. Specimens are usually collected every few hours, and the health-care provider looks for a pattern in the elevation of the different components to rule out or differentially diagnose damage to the heart muscle as a result of a heart attack. If the specimens are not drawn several times within the first 24 hours, it is not possible to establish whether a heart attack really occurred. The myoglobin is usually the first test to be elevated, but most health-care providers like to have more information before proceeding with a differential diagnosis. It is important to remember that other diagnostic procedures (such as an electrocardiogram) will also assist with the diagnosis as well.
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