Myocardial infarction?--a conflict between electrocardiographic changes and biochemical data.

We present a case of hypovolemic shock accompanied by electrocardiographic changes classically associated with acute myocardial infarction. Prompt therapeutic intervention, which included correction of the hypovolemic shock, resulted in stabilization of the patient's clinical course, increased activities of the cardiac-specific enzymes in serum were not documented. Serial electrophoretic determinations of the isoenzymes of serum lactate dehydrogenase did not show the characteristic changes associated with myocardial infarction. Accurate determination of the serum isoenzymes provided valuable diagnostic information which, accompanied by the patient's clinical improvement, militated strongly against the occurrence of myocardial infarction.