How do you work up patients who present with elevated myoglobin in the setting of normal creatinine kinase and exercise intolerance?
For patients who present with elevated myoglobin in the setting of normal creatinine kinase and exercise intolerance, what work up process do you typically proceed with? At what stage of the workup do you typically get a muscle biopsy?
Answer from: at Academic Institution
Myoglobin may originate either from cardiac or skeletal muscle; therefore, I would first try pinpointing the origin with troponins and CK fractions. I would work up the exercise intolerance with a non-ischemic forearm test to determine whether a flat lactate curve is present. In that case, I’d...
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