Physical examination results: the electric axis is obviously left-biased, and creatine kinase 145. Is there any damage to the myocardium?

Creatine kinase 457. Myocarditis cannot be diagnosed. Many diseases can lead to the increase of creatine kinase. Not specific, such as fever, exercise, thyroid disease, muscle injury.

Guiding opinions:

The diagnosis of myocarditis must have a cold history of nearly 3 weeks, abnormal electrocardiogram, elevated creatine kinase isoenzyme and troponin. Creatine kinase alone cannot diagnose myocarditis.

If it is myocarditis, it is recommended to rest and not go to school.

Disease analysis:

Clinically, creatine kinase (CK) is often elevated alone, and myocardial infarction is ruled out through various cardiac examinations. At this time, clinicians need to consider all aspects and make reasonable treatment to avoid misdiagnosis and mistreatment and delay the illness. There are many reasons for the increase of creatine kinase. CK mainly exists in skeletal muscle, brain and myocardial tissue. Under normal circumstances, most of CK is located in muscle cells, and the increase of CK in blood generally indicates that muscle injury has occurred or is occurring.

Guiding opinions:

The increase of CK can be seen in many diseases, such as 1. Myocardial infarction. The level of CK began to increase at 2-4 hours after acute onset, and reached the peak at 12-48 hours, and returned to normal at 2-4 days. The degree of CK increase was basically consistent with the degree of myocardial injury. Therefore, CK can be used for early diagnosis. Acute myocardial infarction, especially for diagnosing myocardial ischemia and subendocardial myocardial infarction, is more sensitive than other enzyme markers. After thrombolytic therapy for myocardial infarction restored the blood flow of occluded vessels, the peak time of CK was advanced. Dynamic detection of CK changes is helpful to observe the condition and evaluate the prognosis. 2. All kinds of myopathy (such as progressive muscular dystrophy, viral myocarditis, polymyositis, crush syndrome and other serious muscle injuries) or increased serum CK after operation. 3. The serum CK increased during cerebrovascular disease, acute brain injury, alcoholism, generalized convulsion and seizure. When myxoedema occurs in hypothyroidism, CK level will also increase. Evaluation of neuromuscular diseases CK detection plays an important role in the diagnosis and evaluation of neuromuscular diseases: 1. Suspected myopathy can be diagnosed early before other symptoms appear. 2. It is helpful to judge whether the symptoms of myasthenia come from muscle tissue itself or nerve dysfunction. 3. It can distinguish various myopathy. For example, muscular dystrophy and congenital myopathy can be distinguished. 4. It can be used to detect the "carriers" of neuromuscular diseases, especially the gene carriers of Duchenne muscular dystrophy. "carriers" with genetic defects will not show any symptoms themselves, but their offspring may become patients. 5. Monitor the course of some fluctuating diseases (mainly inflammatory myopathy), or identify the acute injury period of some metabolic myopathy.

Chronic CK elevation of asymptomatic high creatine kinase is called hypercapnia, which is occasionally seen in normal people. In 1980, Rowland called hyperkalemia without clinical and histopathological evidence of neuromuscular diseases idiopathic hyperkalemia. For patients with clinical symptoms of neuromuscular diseases, a definite diagnosis can be made through various related examinations. Those who meet the following conditions are asymptomatic hyperkalemia: ① occasional increase of serum CK; (2) Persistent high potassium for at least 3 months; ③ Mild nonspecific symptoms (occasionally mild myalgia) are asymptomatic or only found at the time of treatment; ④ No family history of neuromuscular diseases; ⑤ Lack of clinical manifestations of neuromuscular diseases related to hyperkalemia; ⑥ No heart disease (CK-MB and ECG are normal); ⑦ There is no other cause leading to hypercapnia (malignant tumor, alcoholism and drug abuse, systemic metabolic diseases, infection, malignant hyperthermia, thyroid and parathyroid diseases, blood system diseases, pregnancy, drug side effects, etc.). ). For those who are diagnosed as asymptomatic hypercapnia, the following tests should be generally carried out to clarify the reasons: ① nervous system examination, especially muscle strength examination; ② CK determination of family members; ③ Blood lactate test, including basic state, forearm ischemia and exercise; ④ Electromyography of needle electrode; ⑤ Muscle biopsy, routine histology, various histochemical staining, immunohistochemical staining and electron microscopy were performed.

If it is still negative after the above system examination, it can be considered as idiopathic hyperkalemia.

Disease analysis:

Creatine kinase isoenzyme is of great significance in clinical diagnosis. When various diseases occur, including muscle atrophy and myocardial infarction, the level of creatine kinase in human serum rises rapidly. At present, it is considered that measuring creatine kinase activity is more reliable than ECG in diagnosing myocardial infarction.

Guiding opinions:

If it is, if it is myocarditis, I suggest that you do an electrocardiogram examination to clarify the cause and treat it as soon as possible.

Disease analysis:

His clinical manifestations

1, symptoms: fatigue, fever, chest tightness, palpitation, shortness of breath, dizziness, which may lead to cardiac insufficiency or cardiogenic shock in severe cases.

2. Signs: the heart rate increases, which is out of proportion to the increase of body temperature, the heart boundary expands, the murmur changes, and arrhythmia.

Myocarditis can not be judged by creatine kinase alone, but also by ECG and other indicators.

Guiding opinions:

As long as the child's fever has gone down and the symptoms have not come, he can go to school. If you suspect myocarditis, tell your child not to be strenuous and do a systematic examination.

Disease analysis:

Chief complaint: I have a fever and don't drive for 2 days.

Time and cause of onset: a week ago.

Creatine phosphokinase (CPK) mainly exists in skeletal muscle and myocardium, and also exists in brain tissue. It is an enzyme involved in energy metabolism in the body. Clinically, it is mainly used to diagnose myocardial infarction. 2-4 hours after the onset of myocardial infarction, the activity of CPK in blood began to increase, which was earlier than that of aspartate transferase and lactate dehydrogenase in serum.

Clinical significance:

(1) After myocardial infarction, CPK has higher specificity than aspartate aminotransferase and lactate dehydrogenase, but its duration is short, and it returns to normal in 2-4 days.

(2) Viral myocarditis, CPK can also be increased, which has reference value for diagnosis and prognosis.

(3) Progressive muscular dystrophy, polymyositis and muscle injury can also increase CPK.

(4) Severe angina pectoris, pericarditis, atrial fibrillation, cerebrovascular accident, meningitis and heart surgery. , CPK can be increased.

Normal value: inorganic phosphorus method: 0-200 u/dl.

Colorimetry: m (male): 0.55-7.5u/dl.

Guiding opinions:

The increase of creatine phosphokinase and its isoenzyme is an important diagnostic index of acute myocardial infarction. Creatine phosphokinase is an enzyme, which has been proved to be mainly found in skeletal muscle, myocardium and brain tissue, while the concentration of creatine phosphokinase in gastrointestinal tract, uterus, kidney and bladder is only trace. The increase of creatine phosphokinase in serum indicates that there is cell necrosis in the tissue. These enzymes have two components, muscle part and brain part. There are three isoenzymes BB-CPK in plasma.

A high level of acid phosphokinase (CPK) indicates that your cardiovascular system is not good and you need to pay attention to your health.

Try not to smoke, drink or eat foods with high cholesterol.