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</a><h1 class="with-also" itemprop="name">CPK isoenzymes test</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>The creatine phosphokinase (CPK) isoenzymes test measures the different forms of CPK in the blood. CPK is an enzyme found mainly in the heart, brain, and skeletal muscle.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>How the Test is Performed</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>A blood sample is needed. This may be taken from a vein. The test is called a <a test="test" href="./003423.htm">venipuncture</a>.</p><p>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 diagnose certain conditions.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>How to Prepare for the Test</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>No special preparation is needed in most cases.</p><p>Tell your provider about all the medicines you are taking. Some drugs can interfere with test results. Drugs that can increase CPK measurements include the following:</p><ul><li>Alcohol</li><li>Amphotericin B</li><li>Certain anesthetics</li><li>Cocaine</li><li>Fibrate drugs</li><li>Statins</li><li>Steroids, such as dexamethasone </li></ul><p>This list is not all-inclusive.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>How the Test will Feel</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>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.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Why the Test is Performed</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>This test is done if a <a test="test" href="./003503.htm">CPK test</a> shows that your total CPK level is elevated. CPK isoenzyme testing can help find the exact source of the damaged tissue.</p><p>CPK is made of three slightly different substances:</p><ul><li>CPK-1 (also called CPK-BB) is found mostly in the brain and lungs</li><li>CPK-2 (also called CPK-MB) is found mostly in the heart</li><li>CPK-3 (also called CPK-MM) is found mostly in skeletal muscle </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>What Abnormal Results Mean</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>Higher-than-normal CPK-1 levels:</p><p>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:</p><ul><li><a test="test" href="./000768.htm">Brain cancer</a></li><li><a test="test" href="./000028.htm">Brain injury</a> (due to any type of injury including, stroke, or bleeding in the brain)</li><li>Electroconvulsive therapy</li><li>Pulmonary infarction</li><li><a test="test" href="./003200.htm">Seizure</a></li></ul><p>Higher-than-normal CPK-2 levels:</p><p>CPK-2 levels rise 3 to 6 hours after a <a test="test" href="./000195.htm">heart attack</a>. If there is no further heart muscle damage, the level peaks at 12 to 24 hours and returns to normal 12 to 48 hours after tissue death.</p><p>Increased CPK-2 levels may also be due to:</p><ul><li>Electrical injuries</li><li>Heart <a test="test" href="./007110.htm">defibrillation</a> (purposeful shocking of the heart by medical personnel)</li><li>Heart injury (for instance, from a car accident)</li><li>Inflammation of the heart muscle usually due to a virus (myocarditis)</li><li>Open heart surgery </li></ul><p>Higher-than-normal CPK-3 levels are most often a sign of muscle injury or muscle stress. They may be due to:</p><ul><li><a test="test" href="./000024.htm">Crush injuries</a></li><li>Dermatomyositis or polymyositis</li><li>Muscle damage due to drugs or being immobile for a long time (<a test="test" href="./000473.htm">rhabdomyolysis</a>)</li><li><a test="test" href="./001190.htm">Muscular dystrophy</a></li><li>Myopathy</li><li><a test="test" href="./001245.htm">Myositis</a> (skeletal muscle inflammation)</li><li>Receiving many intramuscular injections</li><li>Recent nerve and muscle function testing (electromyography)</li><li>Recent seizures</li><li>Recent surgery</li><li>Rhabdomyolysis</li><li>Strenuous exercise </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Considerations</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>Factors that can affect test results include <a test="test" href="./003419.htm">cardiac catheterization</a>, intramuscular injections, recent surgery, and vigorous and prolonged exercise or immobilization.</p><p>Isoenzyme testing for specific conditions is about 90% accurate.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Creatine phosphokinase - isoenzymes; Creatine kinase - isoenzymes; CK - isoenzymes; Heart attack - CPK; Crush - CPK</p></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Images</h2></div><div class="section-button"><button type="submit" aria-controls="section-tnails" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/10026t.jpg" alt="Blood test" title="Blood test" class="side-img"/><a href="../imagepages/10026.htm">Blood test</a></li>
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</ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Habib G. Cardiology. In: Harward MP, ed. <em>Medical Secrets</em>. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 4.
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</p><p>Marshall WJ, Lapsley M, Day A, Shipman K. Plasma proteins and enzymes. In: Marshall WJ, Lapsley M, Day A, Shipman K, eds. <em>Clinical Chemistry</em>. 9th ed. St Louis, MO: Elsevier; 2021:chap 16.</p><p>Panteghini M. Serum enzymes. In: Rifai N, Chiu RWK, Young I, Burnham CD, Wittwer CT, eds. <em>Tietz Textbook of Laboratory Medicine</em>. 7th ed. St Louis, MO: Elsevier; 2023:chap 32.</p><p>Pincus MR, Carty RP. Clinical enzymology. In: McPherson RA, Pincus MR, eds. <em>Henry's Clinical Diagnosis and Management by Laboratory Methods</em>. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 21.</p></div></div></section>
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<section><div class="section"><div class="section-header"><div class="section-title"><h2>Review Date 1/1/2023</h2></div><div class="section-button"><button type="submit" aria-controls="section-version" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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