Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (865 page)

   Peripartum period for first day beginning within 30 minutes

   Acute cholecystitis

   Hyperthyroidism and chronic renal failure, which may cause persistent increase although the proportion of CK-MB remains low

   Acute exacerbation of obstructive lung disease

   Drugs (e.g., aspirin, tranquilizers)

   Carbon monoxide poisoning

   Some neoplasms:

   For example, prostate, breast

   Ninety percent of patients following cryotherapy for prostate carcinoma with peak at 16 hours to about five times ULN; similar increase in total CK

   Percent activity distribution of CK isoenzymes in tissue

   A CK-MB >15–20% should raise the possibility of an atypical macro CK-MB.

Not Increased In

   Angina pectoris, exercise testing for CAD, or pericarditis. Elevation implies necrosis of cardiac muscle, even if a discrete infarct is not identified.