CPK isoenzymes test
St. Luke's Hospital
Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
Find a Physician Payment Options Locations & Directions
Follow us on: facebook twitter Mobile Email Page Email Page Print Page Print Page Increase Font Size Decrease Font Size Font Size
America's 50 Best Hospitals
Meet the Doctor
Spirit of Women
Community Health Needs Assessment
Home > Health Information

Women's Center

CPK isoenzymes test

Definition

The CPK isoenzymes test measures the different forms of creatine phosphokinase (CPK) in the blood. CPK is an enzyme found mainly in the heart, brain, and skeletal muscle.

See also: Creatine phosphokinase test

Alternative Names

Creatine phosphokinase - isoenzymes; Creatine kinase - isoenzymes; CK - isoenzymes

How the Test is Performed

Blood is typically drawn from a vein, usually from the inside of the elbow or the back of the hand. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood.

Next, the health care provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. The elastic band is removed from your arm.

Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding.

If you are in the hospital, this test may be repeated over 2 or 3 days. A significant rise or fall in the total CPK or CPK isoenzymes can help your health care provider diagnosis certain conditions.

How to Prepare for the Test

Usually, no special preparation is necessary.

Tell your doctor about all the medications you are taking. Certain medications can interfere with test results. Drugs that can increase CPK measurements include the following:

  • Alcohol
  • Amphotericin B
  • Certain anesthetics
  • Cocaine
  • Fibrate drugs
  • Statins
  • Steroids such as dexamethasone

This list is not all-inclusive.

How the Test Will Feel

When the needle is inserted to draw blood, you may feel moderate pain, or only a prick or stinging sensation. Afterward, there may be some throbbing.

Why the Test is Performed

This test is done if a CPK test reveals that your total CPK level is elevated. CPK isoenzyme testing can help pinpoint the exact source of the damaged tissue.

CPK is made of three slightly different substances:

  • CPK-1 (also called CPK-BB) is found mostly in the brain and lungs
  • CPK-2 (also called CPK-MB) is found mostly in the heart
  • CPK-3 (also called CPK-MM) is found mostly in skeletal muscle

What Abnormal Results Mean

Higher-than-normal CPK-1 levels:

Because CPK-1 is found mostly in the brain and lungs, injury to either of these areas can increase CPK-1 levels. Increased CPK-1 levels may be due to:

  • Brain cancer
  • Brain injury (due to injury, stroke, or bleeding in the brain)
  • Electroconvulsive therapy
  • Pulmonary infarction
  • Seizure

Higher-than-normal CPK-2 levels:

CPK-2 levels rise 3 - 6 hours after a heart attack. If there is no further heart muscle damage, the level peaks at 12 - 24 hours and returns to normal 12 - 48 hours after tissue death.

Increased CPK-2 levels may also be due to:

  • Electrical injuries
  • Heart defibrillation (purposeful shocking of the heart by medical personnel)
  • Heart injury (for instance, from a car accident)
  • Inflammation of the heart muscle usually due to a virus (myocarditis)
  • Open heart surgery

CPK-2 levels do NOT usually rise with chest pain caused by angina, pulmonary embolism (blood clot in the lung), or congestive heart failure.

Higher-than-normal CPK-3 levels are usually a sign of muscle injury or muscle stress and may be due to:

  • Crush injuries
  • Muscle damage due to drugs or being immobile for a long time (rhabdomyolysis)
  • Muscular dystrophy
  • Myositis (skeletal muscle inflammation)
  • Receiving many intramuscular injections
  • Recent nerve and muscle function testing (electromyography)
  • Recent seizures
  • Recent surgery
  • Strenuous exercise

Considerations

Factors that can affect test results include cardiac catheterization, intramuscular injections, recent surgery, and vigorous and prolonged exercise or immobilization.

Isoenzyme testing for specific conditions is about 90% accurate.

References

Anderson JL. ST segment elevation acute myocardial infarction and complications of myocardial infarction. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 72.

Barohn RJ. Muscle diseases. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 447.

Cannon CP, Lee TH. Approach to the patient with chest pain. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 49.



Review Date: 2/17/2011
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
adam.com


Back  |  Top
About Us
Contact Us
History
Mission
Locations & Directions
Quality Reports
Annual Reports
Honors & Awards
Community Health Needs
Assessment

Newsroom
Services
Brain & Spine
Cancer
Heart
Maternity
Orthopedics
Pulmonary
Sleep Medicine
Urgent Care
Women's Services
All Services
Patients & Visitors
Locations & Directions
Find a Physician
Tour St. Luke's
Patient & Visitor Information
Contact Us
Payment Options
Financial Assistance
Send a Card
Mammogram Appointments
Health Tools
My Personal Health
mystlukes
Spirit of Women
Health Information & Tools
Clinical Trials
Health Risk Assessments
Employer Programs -
Passport to Wellness

Classes & Events
Classes & Events
Spirit of Women
Donate & Volunteer
Giving Opportunities
Volunteer
Physicians & Employees
For Physicians
Remote Access
Medical Residency Information
Pharmacy Residency Information
Physician CPOE Training
Careers
Careers
St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
Copyright © St. Luke's Hospital Website Terms and Conditions  |  Privacy Policy  |  Patient Notice of Privacy Policies PDF Sitemap St. Luke's Mobile