Biochemical and morphological markers in the post mortem diagnosis of ischemic heart distress.

The purpose of the present study was to analyze the effectiveness of different biochemical markers used clinically or proposed for the post mortem diagnosis of myocardial infarction in medico-legal practice. We analyzed seven biochemical parameters (CK, CK-MB, LDH, myoglobin, myosin, cathepsin D and total proteins) in pericardial fluid, vitreous humor and femoral vein serum from 34 cadavers. The results were compared with data from macro- and microscopic studies. Our results suggest that biochemical markers are applicable in cases in which the lack of morphological data makes diagnosis uncertain, and are helpful in ruling out myocardial infarction. The sample material of choice for biochemical tests is the pericardial fluid, and the most informative markers are myoglobin, myosin, CK-MB and cathepsin D.