Abstract
Macro enzymes are high molecular mass complexes that consist of normal serum enzymes and protein-immunoglobulins. Creatine kinase (CK) is a muscle enzyme that has three isoenzymes. Two types of macro CK have been described; Macro CK type 1 and macro CK type 2. We report a case where cardiac enzymes were persistently elevated in the absence of myocardial injury. The false elevation was secondary to the presence of macro CK type 1 yielding aberrantly increased CK-MB. Our patient lacked clinical as well as electrocardiographic (EKG) changes to validate myocardial ischemia. Apperception of diagnosing falsely elevated cardiac markers is imperative to avoid unnecessary procedures Key words: Macro CK, ischemia, myocardial infraction.
Highlights
The use of cardiac markers in the evaluation of myocardial injury is invaluable
Macro enzymes are high molecular mass complexes that consist of normal serum enzymes and protein-immunoglobulins
We report a case of an 80-year-old African American female with a past medical history significant for coronary artery disease, moderate mitral valve regurgitation, diabetes mellitus, hypertension, and
Summary
The use of cardiac markers in the evaluation of myocardial injury is invaluable. Interpretation of this data ought to be viewed in concert with the clinical picture and the electrocardiogram. Failure to acknowledge the significance of the conjunctive criteria of myocardial injury may lead the physician astray and may result in potentially unnecessary investigations. In our patient persistent elevation of CK was secondary to Macro enzymes CK type 1. Macro enzymes are high molecular mass complexes that consist of normal serum enzymes and protein-immunoglobulins. Work up in addition to literature review of the subject
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