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Dr. Andrew Rynne

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What do these cardiac enzymes levels indicate?

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Dr. Shoaib Khan

General & Family Physician

Practicing since :2009

Answered : 9409 Questions

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Posted on Sat, 9 Aug 2014 in Hypertension and Heart Disease
Question: My blood test shows CK-NAC/CPK = 264 U/L and CK-MB = 18 IU/L. Anything wrong?
doctor
Answered by Dr. Shoaib Khan 2 hours later
Brief Answer:
Could be a cause for concern

Detailed Answer:
Hello sir and welcome.

Thank you for writing to us.

I have gone through your query with diligence and would like you to know that I am here to help.

I would first like your help with some information sir, if you do not mind, this information will help me in assisting you better.

-What was the indication to conduct these investigations?
-Did you experience any symptoms like chest pain, sweating, feeling of lump in throat, shoulder pain, pain in left arm, etc.?
-What was the gap between the appearance of symptoms and the conducted tests (approximately in hours)?

The above mentioned test results are for cardiac enzymes which are usually elevated in the case of an acute myocardial infarction (heart attack), vigorous exercise, cerebral vascular disease, skeletal muscle disease, and electrolyte imbalances. I would recommend the following without further ado:
-EKG(ECG)
-2D echo
-Complete blood count
-Blood investigation of electrolyte levels
-Consultation with cardiologist

I do not wish to alarm you, but the above readings could be a cause for concern until proved otherwise. Please do not take this lightly until your doctor says otherwise.

I hope you find my response helpful and informative sir. I hope you can also write back to me with a response to the queries I had if you have time, if you do not please visit a doctor for the above mentioned investigations immediately.

Wishing you the best.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shoaib Khan 12 hours later
It was done after TMT showed +ve variation. I went for the test due to fatique while walking. Pls note that i was found to have MVP (Incidental finding) 10 yes back. I request u to give reply to my following questions.

1. Does the +ve changes in TMT can be correlated to MVP?
2. Whether enzyme count was elevated since, blood sample was collected immediately after undergoing TMT?.
doctor
Answered by Dr. Shoaib Khan 2 hours later
Brief Answer:
Very good queries sir, answered them for you

Detailed Answer:
Hello once again sir.

I would be more than happy to help you. You have asked me some very good questions sir, I really admire your need to learn more and understand your readings and condition better.

1. MVP has shown to cause a false-positive variation in the TMT, which is why many other investigations are recommended after a positive result in seen in a patient with MVP, to make sure the positive result is a true-positive or a false-positive. They include:
-Coronary angiography
-ECG (EKG)
-2D echo scan

2. Yes it could be possible, as vigorous exercise is one of the causes for elevated cardiac enzymes. It will have to be repeated.

Please do not hesitate to ask me anything sir, I believe an educated patient is the safest one to send back home.

Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shoaib Khan 5 hours later
No abnormality in 2D echo test, except MVP.
I have no symptoms of chest pain. Should I necessarily undergo coronary angiogram?
doctor
Answered by Dr. Shoaib Khan 18 minutes later
Brief Answer:
Not mandatory sir, let your doctor decide

Detailed Answer:
Hello once again sir.

In my opinion, only if other indications are present the necessity of a coronary angiography would be required. So let us leave this decision to your treating doctor.

But do make sure a repeat cardiac enzyme test is conducted at the earliest sir. This would help for a comparison.

I hope you recover completely and the cause for the elevated enzymes was something simple and nothing to cause concern.

Wishing you the best sir.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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