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Analysis of routine blood test - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Good Posted in: X-ray, Lab tests and Scans
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
User :   Hi,
As a routine test I got my blood test done . The package included cardiac enzymes also. The CPK value was 78 however the CPK-MB shows 10. What could be the problem. I am ok otherwise. BP is 120/80. Diabetes is under control. Age is 38. What should I do.
Doctor :   Hi
Doctor :   Let me read your query
User :   ok
Doctor :   Ok
User :   Have u read my query
Doctor :   May I know the units?
Doctor :   of CPKs?
User :   U/L
User :   SGOT is 23
Doctor :   Ok
Doctor :   The CPK is normal in value
Doctor :   normally it is 12-80
User :   Yeah. But the MB ???
Doctor :   CPK-MB indicates mainly skeletal muscle damage
Doctor :   not specific to cardiac muscle
User :   But I read on the Net that it is a specific cardiac marker
Doctor :   I shall explain you
User :   Ok
Doctor :   CPK, if it is high
Doctor :   then it does indicate muscular damage
Doctor :   Now what is the reference range given for CPK in your report?
User :   35 - 232 U/L
User :   and for MB it is 0 - 6 U/L
Doctor :   Ok
Doctor :   Now the ratio of that has to be seen
Doctor :   that is 10/78
User :   it is quite high.
Doctor :   CPK-MB, comes into picture when there is increase in CPK levels
Doctor :   this ratio indicates
Doctor :   very less CPK-MB compared to CPK
Doctor :   Now this test cannot be taken as conclusive
Doctor :   but you shall need to get supportive tests
Doctor :   for reassurance
Doctor :   cant be left alone as well
Doctor :   the supporting tests are mainly cardiac tests like
Doctor :   ECG, Echo and TMT
Doctor :   in the same order
User :   ok. Will Troponin T be required
Doctor :   If the ECG and Echo are normal, then you shall be subjected to a TMT
User :   Anyway I will meet a Cardiologist tomorrow
Doctor :   ECG progressive changes are fine enough to detect the cardiac damage
User :   Since today is sunday I wanted to discuss
Doctor :   Sure
User :   But is there a likelihood that there was a cardiac event in the past few days. The test was done on 27-May and I got the results yesterday only
Doctor :   Ok
Doctor :   How about your symptoms?
User :   Nothing much. In fact I started walking some 15 days back and after that my sugar levels have normalized and I am feeling better
Doctor :   Ok
Doctor :   How do you tolerate exercise?
User :   Is it a possibility that the walking induced some muscle breakdown which has led to these odd values of CPK-MB
User :   Quite well . I am walking 40 minutes without feeling strain.
Doctor :   That is a possibility
Doctor :   Ok, your symptoms are not supportive
Doctor :   CPK-MB by itself cannot exclusively determine your cardiac status
Doctor :   hence you should be aware of that
Doctor :   other than heart damage, other possible cause for it getting elevated
Doctor :   are myocarditis
Doctor :   a viral infection of the heart
User :   I got an ECG done yesterday night. A junior doctor saw it also. The cardiologist was not available at that time. He said the ECG seemed normal but I am not sure if he could interpret. But ECG is similar to the one I had got done a year back and it was declared within normal limits by the Cardiologist
Doctor :   May I know if you have got your cholesterol test done?
Doctor :   Ok, that is fine
Doctor :   The Junior doctor would have been able to interpret if there were any acute changes
User :   Yes. It is 204, TriGly is 120. HDL is 48 and Direct LDL is 131
User :   Ok
Doctor :   Ok
Doctor :   Have you been taking any medicines for cholesterol?
User :   No.
Doctor :   Ok
Doctor :   So in total, your CPK-MB is slightly elevated
User :   Yes.
Doctor :   which has to be confirmed with cardiac tests which I mentioned above
User :   Ok.
Doctor :   if your cardiologist suspects, then he might ask for a Troponin test, which is more specific than CPK-MB
User :   But what is your opinion in terms of probability.
Doctor :   but the ratio, that is relative index is in your favor
Doctor :   Probability is like prediction, which I should not do as a doctor
Doctor :   hence I should only make necessary remarks after monitoring of other tests
Doctor :   Sorry for that
User :   Ok
Doctor :   Meanwhile, if you get any symptoms, then I would suggest you to go the Casualty
Doctor :   and also stay calm, rest well
User :   Ok. Thanks. I started taking aspirin. Will wait till tomorrow.
Doctor :   Sure
Doctor :   Aspirin, take it after food
User :   Yes.
Doctor :   that is my advice
Doctor :   And if you want further clarification, you can always consult our cardiologist
User :   Is it possible to know your name and qualification
Doctor :   Dr.XXX
Doctor :   I am Dr.XXX, XXX
User :   Ok. Thanks Dr. Bye.
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