<prompt> Flipping effect is ?LDH 1 LDH 2LDH2LDH1LDH 2 LDH 3LDH 3LDH 2  <response>: Ref. API Textbook of Medicine. Pg. 798 Lactate dehydrogenase, tetrameric enzyme with 4 subunits,4 Subunits with 2 isoforms - H isoform Heart M isoform MuscleHeart RBCs - LDH-1 4H;Reticuloendothelial system - LDH-2 3H1MLungs - LDH-3 2H2MKidneys, placenta, pancreas - LDH-4 1H3MLiver striated muscle - LDH-5 4MFlipping effectUsually LDH 2 in predominant in serum LDH 1 is predominant in heartHigher levels of LDH 1 than LDH 2 Flipped pattern is suggestive of myocardial infarction 