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Creatine phosphokinase test

CPK test

 

Creatine phosphokinase (CPK) is an enzyme in the body. It is found mainly in the heart, brain, and skeletal muscle. This article discusses the test to measure the amount of CPK in the blood.

How the Test is Performed

 

A blood sample is needed. This may be taken from a vein. The procedure is called a venipuncture.

This test may be repeated over 2 or 3 days if you are a patient in the hospital.

 

How to Prepare for the Test

 

No special preparation is needed most of the time.

Tell your health care provider about any medicines you are taking. Drugs that can increase CPK measurements include amphotericin B, certain anesthetics, statins, fibrates, dexamethasone, alcohol, and cocaine.

 

How the Test will Feel

 

You may feel slight pain when the needle is inserted to draw blood. Some people feel only a prick or stinging sensation. Afterward, there may be some throbbing.

 

Why the Test is Performed

 

When the total CPK level is very high, it most often means there has been injury or stress to muscle tissue, the heart, or the brain.

Muscle tissue injury is most likely. When a muscle is damaged, CPK leaks into the bloodstream. Finding which specific form of CPK is high helps determine which tissue has been damaged.

This test may be used to:

  • Diagnose heart attack
  • Evaluate cause of chest pain
  • Determine if or how badly a muscle is damaged
  • Detect dermatomyositis, polymyositis, and other muscle diseases
  • Tell the difference between malignant hyperthermia and postoperative infection

The pattern and timing of a rise or fall in CPK levels can be significant in making a diagnosis. This is particularly true if a heart attack is suspected.

In most cases other tests are used instead of or with this test to diagnose a heart attack.

 

Normal Results

 

Total CPK normal values:

  • 10 to 120 micrograms per liter (mcg/L)

Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your doctor about the meaning of your specific test results.

 

What Abnormal Results Mean

 

High CPK levels may be seen in people who have:

  • Brain injury or stroke
  • Convulsions
  • Delirium tremens
  • Dermatomyositis or polymyositis
  • Electric shock
  • Heart attack
  • Inflammation of the heart muscle (myocarditis)
  • Lung tissue death (pulmonary infarction)
  • Muscular dystrophies
  • Myopathy
  • Rhabdomyolysis

Other conditions that may give positive test results include:

  • Hypothyroidism
  • Hyperthyroidism
  • Pericarditis following a heart attack

 

Risks

 

Risks associated with having blood drawn are slight but may include:

  • Excessive bleeding
  • Fainting or feeling light-headed
  • Hematoma (blood accumulating under the skin)
  • Infection (a slight risk any time the skin is broken)

 

Considerations

 

Other tests should be done to find the exact location of muscle damage.

Factors that may affect test results include cardiac catheterization, intramuscular injections, trauma to muscles, recent surgery, and heavy exercise.

 

 

References

Anderson JL. ST segment elevation acute myocardial infarction and complications of myocardial infarction. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 73.

Chinnery PF. Muscle diseases. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 429.

Ferri FF. Muscular Dystrophy. In: Ferri FF, ed. Ferri's Clinical Advisor 2016. Philadelphia, PA: Elsevier Mosby; 2016:pp. 832-833.

Ferri FF. Rhabdomyolysis. In: Ferri FF, ed. Ferri's Clinical Advisor 2016. Philadelphia, PA: Elsevier Mosby; 2016:pp. 1081-1083.

Nagaraju K, Lundberg IE. Inflammatory diseases of muscle and other myopathies. In: Firestein GS, Budd RC, Harris ED Jr, et al, eds. Kelley's Textbook of Rheumatology. 9th ed. Philadelphia, PA: Elsevier Saunders; 2012: chap 85.

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        Review Date: 1/9/2015

        Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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