A 55-Year-Old Man Is Taken to a Hospital Emergency Department

A 55-year-old man is taken to a hospital emergency department by helicopter following a rural automobile accident that occurred approximately 3 hours ago.The man,who is having difficulty speaking to the EMTs,is clutching his chest.Upon the man's arrival,the emergency room physician orders a cardiac marker panel that includes serum CK,CK-2 (CK-MB) ,troponin,and myoglobin.The CK-2 value was less than 2% of total CK,which was slightly increased; troponin was normal; and the myoglobin was increased 3 times the upper limit of normal.The physician has asked the laboratory to explain the findings.Which of the following represents the lab's explanation?

A) The assays used to determine these results were nonspecific and not sensitive enough to detect the troponin.
B) Trauma caused by the accident with possible crush injury to the chest caused elevated myoglobin with normal troponin and CK-MB.
C) The use of serum as a specimen interfered with troponin and CK-MB immunoassays giving falsely low results.
D) It is expected that in someone who has had a myocardial infarction in the past that all cardiac biomarker values except myoglobin to have returned to normal.