Serum Glutamic Oxalacetic Transaminase Assay in the Diagnosis of Acute Myocardial Infarction

Manderson, W. G (1959) Serum Glutamic Oxalacetic Transaminase Assay in the Diagnosis of Acute Myocardial Infarction. PhD thesis, University of Glasgow.

Abstract

The assay of serum transaminase, by the spectrophotometric method, is accurate, reproducible and suitable for research purposes. The enzyme is of such stability as to facilitate its clinical usefulness. Only specimens of serum, without evidence of haemolysis should be used for the test. Normal, borderline and high levels of serum transaminase activity have been arbitrarily defined. High levels of serum transaminase activity were demonstrated following 84% of attacks of acute myocardial infarction. The importance of performing the assay 6-24 and 24-48 hours after the onset of acute myocardial infarction is emphasised since, in 14.5% of attacks, too early or too late sampling of the serum accounted for the failure to demonstrate high levels of serum transaminase activity. In those attacks of acute myocardial infarction in which the assay was performed at the recommended times, high levels of serum transaminase activity were detected in 98.2%. There was no evidence that the rise of serum transaminase activity following acute myocardial infarction was due to damage to the liver. Evidence has been presented which suggests that there is a statistical correlation between the level of serum transaminase activity and the degree of peripheral vascular failure developing after acute myocardial Infarction, although serum transaminase activity cannot be used as an index of the degree of peripheral vascular failure in the individual case. High levels of serum transaminase activity are rot found in myocardial ischaemia, although an increase of activity to borderline levels may be demonstrated. Increased serum transaminase activity may be detected in lesions other than acute myocardial infarction. High levels of serum transaminase activity were demonstrated in diseases of the liver, but this matters less than the detection of increased serum transaminase activity in conditions which may be confused with, or complicate, acute myocardial infarction e.g., in dissecting aneurysm of the aorta, acute pulmonary infarction, acute pancreatitis, chronic cholecystitis, arterial embolism and thrombosis and in rapid cardiac arrhythmias. The probable sources of increased serum transaminase activity in conditions other than acute myocardial infarction have been discussed. In differentiating between acute myocardial infarction and other diseases, the demonstration of normal serum transaminase activity at the recommended times after the onset of illness Is supporting evidence against the diagnosis of acute myocardial infarction. Serum transaminase assay cannot replace the electrocardiogram in the diagnosis of acute myocardial infarction. It is a diagnostic aid rather than a substitute for any of the existing diagnostic procedures, although it has been shown to be superior to pyrexia and the ESR, as an index of acute myocardial infarction in the early stages of the illness. (Abstract shortened by ProQuest.).

• Item Type: Thesis (PhD)
• Qualification Level: Doctoral
• Keywords: Medicine, Biochemistry, Histology
• Date of Award: 1959
• Depositing User: Enlighten Team
• Unique ID: glathesis:1959-79293
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 05 Mar 2020 11:02
• Last Modified: 05 Mar 2020 11:02
• URI: https://theses.gla.ac.uk/id/eprint/79293