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Chest pain, elevated cardiac enzymes, taking Isorsobide denitrate, breathlessness. Problem?

Hi. i am still experiencing the left chest pains beneath my left breast radiating to the back. you once suggested that it was gastritis but i had the tests done even my blood sugar was okay. had a resting ecg and one was abnormal and my cardiac enzymes were elevated. cpk around 600 and the other was 500. i also had another ecg which was normal. i also had an echo and the specialist physician says it was okay. she said she doesn t know why my cardiac enzymes were elevated. so i stopped using Isorsobide denitrate 20mg tablets which were prescribed by my doctor. and the pain came with shortness of breath and stabbing attacks. i am now on isorsobide dinitrate and m nolonger experiencing the pain. what could be my problem? Pleas help me
Asked On : Sat, 20 Oct 2012
Answers:  1 Views:  60
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General & Family Physician 's  Response
Hello flossy.jeke, greetings from

I am Dr Sourav Chakraborty and i will be giving answers to your querries , so lets start with your history. Your cardiac enzymes and in particlar CPK is raised; on one occasion is 600 units and other times it is 500 units , right ?. Also you have not mentioned what abnormality your doctor found in the baseline ECG they did for you though you have mentioned echocardiogram done reveals study within normal limits and hence it safely rules out frank myocardial infarction, ischemic heart disease and pericardial effusion . I need to mention this only interpretation of CPK is misleading if you don't correlate it with CPK-MB which is more cardiac muscle specific. Only isolated case of markedly raised CPK has other interpretation which is beyond cardiology. Elevation of CPK is also an indication of damage to muscle. It is therefore indicative of injury, rhabdomyolysis, myositis and myocarditis. Myocarditis can be a cause for you but to be sure , it's better to get a CRP test done for you or better consult with your cardiologist of choice. Needless to say if your doctor rules out myocarditis then i firmly believe you should seek opinion from arheumatologist. Hope i have been able to help you with your complaints. Take care.
Answered: Tue, 30 Oct 2012
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