BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuCPK isoenzymes testCreatine phosphokinase - isoenzymes; Creatine kinase - isoenzymes; CK - isoenzymes; Heart attack - CPK; Crush - CPKThe 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. How the Test is Performed A blood sample is needed. This may be taken from a vein. The test is called a venipuncture.VenipunctureVenipuncture is the collection of blood from a vein. It is most often done for laboratory testing.ImageRead Article Now Book Mark Article 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. How to Prepare for the Test No special preparation is needed in most cases.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:Alcohol Amphotericin B Certain anesthetics Cocaine Fibrate drugs Statins Steroids, such as dexamethasone This list is not all-inclusive. How the Test will Feel 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. Why the Test is Performed This test is done if a CPK test shows that your total CPK level is elevated. CPK isoenzyme testing can help find the exact source of the damaged tissue.CPK testCreatine phosphokinase (CPK) is an enzyme in the body. It is found mainly in the heart, brain, and skeletal muscle. This article discusses the test...ImageRead Article Now Book Mark Article CPK is made of three slightly different substances:CPK-1 (also called CPK-BB) is found mostly in the brain and lungs CPK-2 (also called CPK-MB) is found mostly in the heart CPK-3 (also called CPK-MM) is found mostly in skeletal muscle What Abnormal Results Mean 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 cancerA brain tumor is a group (mass) of abnormal cells that grow in the brain. This article focuses on primary brain tumors in children.ImageRead Article Now Book Mark Article Brain injury (due to any type of injury including, stroke, or bleeding in the brain) Brain injuryA head injury is any trauma to the scalp, skull, or brain. Head injury can be either closed or open (penetrating). A closed head injury means you rec...ImageRead Article Now Book Mark Article Electroconvulsive therapy Pulmonary infarction SeizureSeizureA seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...ImageRead Article Now Book Mark Article Higher-than-normal CPK-2 levels:CPK-2 levels rise 3 to 6 hours after a heart attack. 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.Heart attackMost heart attacks are caused by a blood clot that blocks one of the coronary arteries. The coronary arteries bring blood and oxygen to the heart. ...ImageRead Article Now Book Mark Article Increased CPK-2 levels may also be due to:Electrical injuries Heart defibrillation (purposeful shocking of the heart by medical personnel) DefibrillationCardioversion is a method to bring an abnormal heart rhythm back to normal.ImageRead Article Now Book Mark Article Heart injury (for instance, from a car accident) Inflammation of the heart muscle usually due to a virus (myocarditis) Open heart surgery Higher-than-normal CPK-3 levels are most often a sign of muscle injury or muscle stress. They may be due to:Crush injuries Crush injuriesA crush injury occurs when excessive force or pressure is put on a body part. This type of injury most often happens when part of the body is squeez...Read Article Now Book Mark Article Dermatomyositis or polymyositis Muscle damage due to drugs or being immobile for a long time (rhabdomyolysis) RhabdomyolysisRhabdomyolysis is the breakdown of muscle tissue that leads to the release of muscle fiber contents into the blood. These substances are harmful to ...ImageRead Article Now Book Mark Article Muscular dystrophy Muscular dystrophyMuscular dystrophy (MD) is a group of inherited disorders that cause muscle weakness and loss of muscle tissue, which get worse over time.ImageRead Article Now Book Mark Article Myopathy Myositis (skeletal muscle inflammation) MyositisMyositis is an inflammation or swelling of the muscles. It is most often caused by injury, infection, medicines, or an autoimmune disorder. Dermatom...Read Article Now Book Mark Article Receiving many intramuscular injections Recent nerve and muscle function testing (electromyography) Recent seizures Recent surgery Rhabdomyolysis Strenuous exercise Considerations Factors that can affect test results include cardiac catheterization, intramuscular injections, recent surgery, and vigorous and prolonged exercise or immobilization.Cardiac catheterizationCardiac catheterization involves passing a thin flexible tube (catheter) into the right or left side of the heart. The catheter is most often insert...ImageRead Article Now Book Mark Article Isoenzyme testing for specific conditions is about 90% accurate.Open ReferencesReferencesHabib G. Cardiology. In: Harward MP, ed. Medical Secrets. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 4. Marshall WJ, Lapsley M, Day A, Shipman K. Plasma proteins and enzymes. In: Marshall WJ, Lapsley M, Day A, Shipman K, eds. Clinical Chemistry. 9th ed. St Louis, MO: Elsevier; 2021:chap 16.Panteghini M. Serum enzymes. In: Rifai N, Chiu RWK, Young I, Burnham CD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. St Louis, MO: Elsevier; 2023:chap 32.Pincus MR, Carty RP. Clinical enzymology. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 21.AllVideoImagesTogBlood test - illustration Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. Preparation may vary depending on the specific test.Blood testillustrationBlood test - illustration Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. Preparation may vary depending on the specific test.Blood testillustration Tests for CPK isoenzymes test CPK isoenzymes testTroponin testRelated Information Creatine phosphokinase test(Medical Test)Enzyme(Special Topic)Heart attack(Condition)Chest pain(Symptoms)Angina(Condition)Pulmonary embolus(Condition)Heart failure(Condition)Brain tumor - children(Condition)Head injury - first aid(Injury)Seizures(Symptoms)Heart attack and acute coronary syndrome - InDepth(In-Depth)Coronary artery disease - InDepth(In-Depth)Heart failure - InDepth(In-Depth) Review Date: 1/1/2023 Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. 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CPK isoenzymes testCreatine phosphokinase - isoenzymes; Creatine kinase - isoenzymes; CK - isoenzymes; Heart attack - CPK; Crush - CPKThe 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. How the Test is Performed A blood sample is needed. This may be taken from a vein. The test is called a venipuncture.VenipunctureVenipuncture is the collection of blood from a vein. It is most often done for laboratory testing.ImageRead Article Now Book Mark Article 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. How to Prepare for the Test No special preparation is needed in most cases.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:Alcohol Amphotericin B Certain anesthetics Cocaine Fibrate drugs Statins Steroids, such as dexamethasone This list is not all-inclusive. How the Test will Feel 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. Why the Test is Performed This test is done if a CPK test shows that your total CPK level is elevated. CPK isoenzyme testing can help find the exact source of the damaged tissue.CPK testCreatine phosphokinase (CPK) is an enzyme in the body. It is found mainly in the heart, brain, and skeletal muscle. This article discusses the test...ImageRead Article Now Book Mark Article CPK is made of three slightly different substances:CPK-1 (also called CPK-BB) is found mostly in the brain and lungs CPK-2 (also called CPK-MB) is found mostly in the heart CPK-3 (also called CPK-MM) is found mostly in skeletal muscle What Abnormal Results Mean 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 cancerA brain tumor is a group (mass) of abnormal cells that grow in the brain. This article focuses on primary brain tumors in children.ImageRead Article Now Book Mark Article Brain injury (due to any type of injury including, stroke, or bleeding in the brain) Brain injuryA head injury is any trauma to the scalp, skull, or brain. Head injury can be either closed or open (penetrating). A closed head injury means you rec...ImageRead Article Now Book Mark Article Electroconvulsive therapy Pulmonary infarction SeizureSeizureA seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...ImageRead Article Now Book Mark Article Higher-than-normal CPK-2 levels:CPK-2 levels rise 3 to 6 hours after a heart attack. 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.Heart attackMost heart attacks are caused by a blood clot that blocks one of the coronary arteries. The coronary arteries bring blood and oxygen to the heart. ...ImageRead Article Now Book Mark Article Increased CPK-2 levels may also be due to:Electrical injuries Heart defibrillation (purposeful shocking of the heart by medical personnel) DefibrillationCardioversion is a method to bring an abnormal heart rhythm back to normal.ImageRead Article Now Book Mark Article Heart injury (for instance, from a car accident) Inflammation of the heart muscle usually due to a virus (myocarditis) Open heart surgery Higher-than-normal CPK-3 levels are most often a sign of muscle injury or muscle stress. They may be due to:Crush injuries Crush injuriesA crush injury occurs when excessive force or pressure is put on a body part. This type of injury most often happens when part of the body is squeez...Read Article Now Book Mark Article Dermatomyositis or polymyositis Muscle damage due to drugs or being immobile for a long time (rhabdomyolysis) RhabdomyolysisRhabdomyolysis is the breakdown of muscle tissue that leads to the release of muscle fiber contents into the blood. These substances are harmful to ...ImageRead Article Now Book Mark Article Muscular dystrophy Muscular dystrophyMuscular dystrophy (MD) is a group of inherited disorders that cause muscle weakness and loss of muscle tissue, which get worse over time.ImageRead Article Now Book Mark Article Myopathy Myositis (skeletal muscle inflammation) MyositisMyositis is an inflammation or swelling of the muscles. It is most often caused by injury, infection, medicines, or an autoimmune disorder. Dermatom...Read Article Now Book Mark Article Receiving many intramuscular injections Recent nerve and muscle function testing (electromyography) Recent seizures Recent surgery Rhabdomyolysis Strenuous exercise Considerations Factors that can affect test results include cardiac catheterization, intramuscular injections, recent surgery, and vigorous and prolonged exercise or immobilization.Cardiac catheterizationCardiac catheterization involves passing a thin flexible tube (catheter) into the right or left side of the heart. The catheter is most often insert...ImageRead Article Now Book Mark Article Isoenzyme testing for specific conditions is about 90% accurate.Open ReferencesReferencesHabib G. Cardiology. In: Harward MP, ed. Medical Secrets. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 4. Marshall WJ, Lapsley M, Day A, Shipman K. Plasma proteins and enzymes. In: Marshall WJ, Lapsley M, Day A, Shipman K, eds. Clinical Chemistry. 9th ed. St Louis, MO: Elsevier; 2021:chap 16.Panteghini M. Serum enzymes. In: Rifai N, Chiu RWK, Young I, Burnham CD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. St Louis, MO: Elsevier; 2023:chap 32.Pincus MR, Carty RP. Clinical enzymology. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 21.