Yes it is built in the definition of a myocardial infarction that there must be a rise in the CK-MB fraction or troponin, either I or T isoforms. The rises in these enzymes usually follow the onset of a heart attack by several hours, so that it is best to make the diagnosis based on history and EKG findings. They also do not stay elevated for very long, so that if you miss the event after one week, these enzyme levels will no longer be elevated.
I personally don't think so. Severe MI could be or will be. But most hospitals and doctors are relianced on cardiac enzymes. Apart from that, they also compare the EKG.
Some cardiologists told me that I had a silent attacked. I told them not silent, actually was a very painful chest pain. Just because the enzymes didn't elevate. They told me, it is not a heart attacked. "Go home" no prevention, no treatment. Echo showed MI later. Again, a cardiologist disagreed, he said other cardiologist don't know how to read my ekg so the report was wrong. Now left side of my heart is very lazy. It didn't want to move.
You tell me should we relianced on cardiac enzymes or not?