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Back to Cardiovascular Labs
Creatine kinase
This is one of the most sensitive indicators of
myocardial injury. Creatine kinase is found primarily in the heart,
skeletal muscle, and brain. Acute liver damage has no effect on CK. CK
may be elevated in acute muscular damage (such as seen with hypodermic
injections), hepatic coma, and delirium tremens.
The specimen should
be drawn before injection or at least one hour after injection. Trauma
to muscle during surgery makes CK unreliable for a few postoperative
days.
Isoenzymes
Isoenzyme determinations of CK are also becoming widely
available today. There are three major categories: CK-BB (as found in
brain and lung), CK-MM (as found in skeletal muscle), and the hybrid
CK-MB (in cardiac muscle).
The CK-MB level begins to rise 3-6 hours
after onset of infarct, peaks in 12-24 hours, and returns to normal in
24-48 hours. There is a rough correlation between the size of the
infarct and the degree of CK-MB isoenzyme elevation.
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