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CK, CK-MB, TROPI, myoglobin, cardiac enzymes
This test measures the levels of cardiac biomarkers in your blood. These markers include enzymes, hormones, and proteins.
Cardiac biomarkers show up in your blood after your heart has been under severe stress because it isn't getting enough oxygen. This might be because you've had a heart attack. But these levels can be high for other reasons. The levels of biomarkers are often used to quickly find out the size of a heart attack and how seriously your heart was affected.
These cardiac biomarkers can be used to diagnose a heart attack:
Cardiac troponin. This protein is by far the most commonly used biomarker. It has the highest known sensitivity. It enters into your bloodstream soon after a heart attack. It also stays in your bloodstream days after all other biomarkers go back to normal levels. Current guidelines from the American Heart Association say this is the best biomarker for finding a heart attack. The AHA says to limit use of the other biomarkers. These include CK, CK-MB, and myoglobin.
Creatinine kinase (CK). This enzyme can also be measured several times over a 24-hour period. It will usually at least double if you've had a heart attack. But because levels of CK can go up in many other conditions besides a heart attack, it is not very specific.
CK-MB. This is a subtype of CK. It is more sensitive for heart damage from a heart attack. CK-MB rises 4 to 6 hours after a heart attack. But it is generally back to normal within a day or two. Because of this, it's not helpful when a doctor is trying to figure out whether your recent chest pain was a heart attack.
Myoglobin. This is a small protein that stores oxygen. It is measured occasionally. Myoglobin is sometimes measured in addition to troponin to help diagnose a heart attack. It is also not very specific for finding a heart attack.
You might need this test if your healthcare provider thinks you're having or have recently had a heart attack. You may also need this test if you have symptoms of coronary artery blockage.
Symptoms of coronary blockage may include:
Chest pain or pressure that lasts for more than a few minutes
Pain or discomfort in your shoulders, neck, arms, or jaw
Chest pain that gets worse
Chest pain that doesn’t get better by rest or by taking nitroglycerin
Other symptoms that may happen along with chest pain:
Sweating, cool, clammy skin, or paleness
Shortness of breath
Nausea or vomiting
Dizziness or fainting
Unexplained weakness or fatigue
Rapid or irregular pulse
Your healthcare provider may order other tests to measure other factors in your blood. These include:
Blood gases or other tests to measure oxygen in the blood
Complete blood count
Electrolytes (sodium, potassium, chloride)
Blood fats (cholesterol and triglycerides)
Blood sugar (glucose)
Echocardiogram or ultrasound of the heart muscle
Cardiac catheterization or coronary angiogram
B-type natriuretic peptide (BNP). This is to find stress in the heart or heart failure after a heart attack.
Many things may affect your lab test results. These include the method each lab uses to do the test. Even if your test results are different from the normal value, you may not have a problem. To learn what the results mean for you, talk with your health care provider.
Results are given in nanograms per milliliter (ng/mL). People who are young and healthy usually have little or no cardiac troponin in their blood.
Normal-level results vary. But people with levels of cardiac troponin at or above 0.01 ng/mL are twice as likely to have life-threatening cardiac disease.
The test requires a blood sample, which is drawn through a needle from a vein in your arm.
Taking a blood sample with a needle carries risks that include bleeding, infection, bruising, or feeling dizzy. When the needle pricks your arm, you may feel a slight stinging sensation or pain. Afterward, the site may be slightly sore.
Other factors aren't likely to affect your results.
You don't need to prepare for this test. But be sure your healthcare provider knows about all medicines, herbs, vitamins, and supplements you are taking. This includes medicines that don't need a prescription and any illicit drugs you may use.
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