Critics point out that one of the problems of the dsm is that it is not called the diagnostic and statistical manual of mental disorders and a whole bunch of everyday problems, yet the compilers keep adding everyday problems! it relies too much on empirical evidence and research findings rather than focusing on the person who is at the heart of the diagnostic process. it has strict criteria needed for making a diagnosis and has reduced the number of people who can be labeled with a disorder. it is too resistant to change and too reluctant to add new diagnostic categories, even though today's concerns are far different from those from 1952.

A62-year-old man is being treated for an acute myocardial infarction. he originally came to the ed with substernal chest pain and diaphoresis. given his risk factors of hypertension, diabetes, tobacco use, and family history, he is considered high risk. an ecg in the ed reveals a left-bundle branch pattern, and cardiac enzymes are elevated slightly. after a focused evaluation in the ed, the patient receives iv thrombolytics. although his bundle branch pattern never resolves, the patient is chest pain-free and haemodynamically stable after thrombolysis. two days later, however, the patient reports episodes of recurrent chest discomfort and shortness of breath overnight. in evaluating for potential myocardial reinfarction, which of the following is the most appropriate diagnostic test? - creatinine kinase- dynamic ecg changes- lactate dehydrogenase- myoglobin levels- troponin i level