Distribution of biochemical markers in biologic fluids: application to the postmortem diagnosis of myocardial infarction.

We evaluated the usefulness of postmortem determination of biochemical markers and the ratio of their concentrations in pericardial fluid and serum to diagnose acute myocardial necrosis. One hundred cadavers from routine necropsies were studied. Cases were allocated in diagnostic groups according to the cause of death. Myoglobin and myosin heavy chain concentrations and creatine kinase MB isoenzymes (CK-MB) activities were measured in serum and pericardial fluid. Ratios of the concentrations obtained in these fluids were calculated. Hematoxylin and eosin (H&E) and acridine orange stains were used for microscopy studies. Pericardial fluid-serum ratios of the concentrations of biochemical markers were significantly different. The ratio of the concentrations of myosin is the best indicator of wide-spread muscle damage or cardiac necrosis.