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CASE FILES: BIOCHEMISTRY
B IO C H E M IS T R Y PE A R L S
Coronary heart disease is the most common cause of mortality in
Americans.
Myocardial infarction is suspected with the typical chest pain, ECG
findings of ST segment elevation, and increased cardiac enzymes.
When oxygen is unavailable, the anaerobic glycolytic pathway is
used.
Two shuttles allow for more ATP to be generated under aerobic con-
ditions: the glycerol 3-phosphate shuttle, which functions prima-
rily in skeletal muscle and brain, and the malate-aspartate shuttle,
primarily in the heart, liver, and kidney.
REFERENCES
Braunwald E, Fauci AS, Kasper KL, et al., eds. Harrison’s Principles of Internal
Medicine, 15th ed. New York: McGraw-Hill, 2001.
Devlin TM, ed. Textbook of Biochemistry with Clinical Correlations, 5th ed.
New York: Wiley-Liss, 2002:598-613.
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