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Dr .Saeed ahmed
Dr .Saeed ahmed, Doctor
Category: Cardiology
Satisfied Customers: 4403
Experience:  MBBS/FCPS/MRCP U.K(R), Senior Registrar Cardiology
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Are cpk levels of 95 and troponin 0.497 indicators of a

Customer Question

are cpk levels of 95 and troponin 0.497 indicators of a heart attack?
Submitted: 9 months ago.
Category: Cardiology
Expert:  Dr. Phil, MD replied 9 months ago.

Thanks for this question

CPK is not a good marker of a heart attack

However, the troponin is

That troponin level is high. And it could indicate a heart attack in the right clinical situation

Expert:  Dr .Saeed ahmed replied 9 months ago.

I disagree with above expert,,, cutoff limit of troponin I is 0.50 and this is less than 0.50 so it is a negative test. If symptoms of chest pain, shortness of breath then a repeat test is indicated to see the rise in levels.. I have fellowship in cardiology and working as assistant professor and can help you with further questions, thank you.

Expert:  Dr .Saeed ahmed replied 9 months ago.

...

Expert:  Dr. Phil, MD replied 9 months ago.

It depends on the type of troponin

it would help to know which one you had tested and the reference range

Expert:  Dr. Alan DeCarlo replied 9 months ago.

Agree as follows. Yes, it depends on the type of troponin. Yes, CPK is not specific unless the myocardial fraction is elevated; but even that could be other things like myocarditis, pericardiits etc.

Everything also depends on laboratory reference ranges. And then with cardiac enzymes time is always a factor. That's why in borderline situations that are absolutely not clear cut, patients are either admitted or kept in the ED for repeat EKGs and enzyme markers.

And then of course there is everything else that goes with it all. history, clinical situation, physical exam....on and on. None of it can be taken out of the overall context

Expert:  Dr. Phil, MD replied 9 months ago.

Thanks for this question.

Please don't forget a positive rating. I appreciate it. :)

If you have more questions, just reply.

Customer: replied 9 months ago.
My cousin had the .497 level ref range isn't on the paper but he needed two stents put in and another me was questioning the levels so I am lost. Then what troponin level is a sure indicator?
Expert:  Dr. Phil, MD replied 9 months ago.

That would be a positive result. Probably a mild heart attack

Expert:  Dr .Saeed ahmed replied 9 months ago.

Thank you for your question, Let me explain the situation. If your cousin had chest pain, apprehension and shortness of breath and ECG showed ST elevations the these levels of troponin are non diagnostic and only used for prognosis.. Even if these are normal with ST elevation on ECG this will be considered acute heart attack. Low troponins in this situation will only help to estimate to outcome or prognosis.. I am working as assistant professor of cardiology in a tertiary care hospital and see more than 50 patients with acute heart attack on daily basis... let me know if you have questions, thank you.

Expert:  Dr. Phil, MD replied 9 months ago.

Thanks for this question.

Please don't forget a positive rating. I appreciate it. :)

If you have more questions, just reply.

Customer: replied 9 months ago.
Dr Ahmed in your opinion what troponin level would be a sign of a heart attack?
Expert:  Dr. Phil, MD replied 9 months ago.

I would say anything above 0.5

Expert:  Dr .Saeed ahmed replied 9 months ago.

Thank you for your reply twiggs.... If person or patient does not have symptoms of chest pain and shortness of breath then any levels above 0.5 for troponin I are indicative of a heart attack. While if there are symptoms of chest pain and shortness of breath which increase with activity then these levels do not matter, in such cases ECG is first diagnostic tool even before troponin levels. ECG changes in such cases make the main diagnosis of a possible heart attack... Let me know if you have questions. Thank you.

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