Creatine phosphokinase - isoenzymes; Creatine kinase - isoenzymes; CK - isoenzymes

Higher-than-normal CPK-1 levels:

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:

• Brain cancer
• Brain injury (due to injury, stroke, or bleeding in the brain)
• Electroconvulsive therapy
• Pulmonary infarction
• Seizure

Higher-than-normal CPK-2 levels:

CPK-2 levels rise 3 - 6 hours after a heart attack. If there is no further heart muscle damage, the level peaks at 12 - 24 hours and returns to normal 12 - 48 hours after tissue death.

Increased CPK-2 levels may also be due to:

• Electrical injuries
• Heart defibrillation (purposeful shocking of the heart by medical personnel)
• Heart injury (for instance, from a car accident)
• Inflammation of the heart muscle usually due to a virus (myocarditis)
• Open heart surgery

CPK-2 levels do NOT usually rise with chest pain caused by angina, pulmonary embolism (blood clot in the lung), or congestive heart failure.

Higher-than-normal CPK-3 levels are usually a sign of muscle injury or muscle stress and may be due to:

• Crush injuries
• Muscle damage due to drugs or being immobile for a long time (rhabdomyolysis)
• Muscular dystrophy
• Myositis (skeletal muscle inflammation)
• Receiving many intramuscular injections
• Recent nerve and muscle function testing (electromyography)
• Recent seizures
• Recent surgery
• Strenuous exercise

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Review Date: 02/17/2011
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)