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Are cpk levels of 95 and troponin 0.497 indicators of a

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heart attack?...
are cpk levels of 95 and troponin 0.497 indicators of a heart attack?
Submitted: 1 year ago.Category: Cardiology
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2/18/2016
Cardiologist: Dr. Phil, MD, Medical Doctor replied 1 year ago
Dr. Phil, MD
Dr. Phil, MD, Medical Doctor
Category: Cardiology
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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

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Cardiologist: Dr .Saeed ahmed, Doctor replied 1 year ago
Dr .Saeed ahmed
Category: Cardiology
Satisfied Customers: 4,471
Experience: MBBS/FCPS/MRCP U.K(R), Senior Registrar Cardiology
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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.

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Cardiologist: Dr .Saeed ahmed, Doctor replied 1 year ago

...

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Cardiologist: Dr. Phil, MD, Medical Doctor replied 1 year ago

It depends on the type of troponin

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

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Cardiologist: Dr. Alan DeCarlo, Medical Doctor replied 1 year ago
Dr. Alan DeCarlo
Dr. Alan DeCarlo, Medical Doctor
Category: Cardiology
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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

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Cardiologist: Dr. Phil, MD, Medical Doctor replied 1 year ago

Thanks for this question.

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

If you have more questions, just reply.

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Customer reply replied 1 year 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?
Cardiologist: Dr. Phil, MD, Medical Doctor replied 1 year ago

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

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Cardiologist: Dr .Saeed ahmed, Doctor replied 1 year 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.

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Cardiologist: Dr. Phil, MD, Medical Doctor replied 1 year ago

Thanks for this question.

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

If you have more questions, just reply.

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Customer reply replied 1 year ago
Dr Ahmed in your opinion what troponin level would be a sign of a heart attack?
Cardiologist: Dr. Phil, MD, Medical Doctor replied 1 year ago

I would say anything above 0.5

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Cardiologist: Dr .Saeed ahmed, Doctor replied 1 year 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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