Role of cardiac markers in evaluation of suspected myocardial infarction. Selecting the most clinically useful indicators.

In the workup of a patient with chest pain, knowing which cardiac marker or markers to measure is not always easy. Many factors affect the choice of the most clinically effective test: elapsed time after onset of pain, possible presence of skeletal muscle injury, potential delays in receiving test results, to name a few. In this review article, Dr Mercer compares the current cardiac markers, rates them according to the 10 characteristics of the ideal marker, and offers guidelines for selecting the appropriate marker in various clinical settings.