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Diagnose skeletal or myocardial muscle injury. Serum myoglobin is generally detectable earlier than is CK or CK-MB increase in patients with acute myocardial infarction.1 Serum myoglobin was found also in 50% of patients with acute coronary insufficiency. It is thought to define a population of small infarcts of myocardium. It correlates with size of infarct.1 Diagnose rhabdomyolysis.2 Myoglobin appears with trauma, ischemia, malignant hyperthermia, exertion, dermatomyositis, polymyositis, and muscular dystrophy.3
Lacks specificity in diagnosis of acute MI, since increased myoglobin levels occur after intramuscular injections.4 Increased serum myoglobin has been reported after a high voltage electrical accident.4 As an index of myocardial infarct, myoglobin returns rapidly to baseline levels.1
Serum myoglobin is rapidly cleared by the kidneys. Urine myoglobin levels were not detected after myocardial infarct.4 Elevated myoglobin levels may be associated with cocaine abuse.5 Other conditions which cause elevation of serum myoglobin include open heart surgery, exercise, progressive muscular dystrophy, shock, and renal failure.1 It is increased in azotemic subjects and not effected by dialysis.6
1. Isakov A, Shapira I, Burke M, Almog C. Serum myoglobin levels in patients with ischemic myocardial insult. Arch Intern Med. 1988 Aug; 148(8):1762-1765. PubMed 3401097
2. Kaiser HF, Rumpf KW, Sold G, Kreuzer H. Serum myoglobin in rhabdomyolysis. JAMA. 1982 Mar 26; 247(12):1697. PubMed 7062478
3. Kagen LJ. Approach to the patient with myopathy. Bull Rheum Dis. 1983; 33(2):1-8. PubMed 6860842
4. Drexel H, Dworzak E, Kirchmair W, Milz MM, Puschendorf B, Dienstl F. Myoglobinemia in the early phase of acute myocardial infarction. Am Heart J. 1983 Apr; 105(4):642-651. PubMed 6837418
5. Pogue VA, Nurse HM. Cocaine-associated acute myoglobinuric renal failure. Am J Med. 1989 Feb; 86(2):183-186. PubMed 2913784
6. Feinfeld DA, Verger C, Briscoe AM, et al. Serum myoglobin in patients on intermittent and continuous ambulatory peritoneal dialysis. Clin Nephrol. 1987 Sep; 28(3):144-146. PubMed 3665208
Andersen PT, Moller-Petersen J, Henneberg EW, Egeblad K. Hypermyoglobinemia after successful arterial embolectomy. Surgery. 1987 Jul; 102(1):25-31. PubMed 3296265
Gibler WB, Gibler CD, Weinshenker E, et al. Myoglobin as an early indicator of acute myocardial infarction. Ann Emerg Med. 1987 Aug; 16(8):851-856. PubMed 3619163
Kasik JW, Leuschen MP, Bolam DL, Nellson RM. Rhabdomyolysis and myoglobinemia in neonates. Pediatrics. 1985 Aug; 76(2):255-258. PubMed 4022700
Seguin J, Saussine M, Ferriere M, et al. Comparison of myoglobin and creatine kinase MB levels in the evaluation of myocardial injury after cardiac operations. J Thorac Cardiovasc Surg. 1988 Feb; 95(2):294-297. PubMed 3257537
