• Can J Emerg Med · Jan 2010

    Case Reports

    Discordant creatine kinase and cardiac troponin T in the workup of acute coronary syndrome.

    • Jamil Kanji and Jerome Fan.
    • Department of Internal Medicine, McMaster University, Hamilton, Ontario.
    • Can J Emerg Med. 2010 Jan 1;12(1):64-8.

    AbstractA 55-year-old man presented to the emergency department (ED) following 2 episodes of typical cardiac chest pain and nonspecific electrocardiogram findings. His serial cardiac marker assays revealed an elevated total creatine kinase (CK) and 2 negative cardiac troponin levels. Because of a high clinical suspicion of acute coronary syndrome, a total creatine kinase MB mass was obtained and found to be elevated. Subsequent cardiac angiography demonstrated a significantly flow-limiting coronary artery lesion, and stenting was performed. This case demonstrates that simultaneous CK and troponin measurements may have utility in selected ED patients with chest pain. The interpretation of discordant CK and troponin levels is discussed.

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