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In 2012, I Called 911 With Chest Pain And Low

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Posted on Thu, 25 Jun 2020
Question: In 2012, I called 911 with chest pain and low blood sugar of 34 so paramedics took me to ER. My Troponin T was undetectable, my CK-MB was 2.7 (cutoff 2.8) and I read that over 2.5 means heart damage. My ECG was normal and undetectable Troponin T and CPK of 73 (ref range 0-175) so the ER dr said I was fine and he didn't know why I had chest pain. Now looking back, I see a CK-MB over 2.5 could mean heart damage. Could this be why I'm having symptoms now? I do have high LDL and systemic inflammation. Did I have a heart attack?
doctor
Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome to Ask a Doctor service!

Regarding your concern, I would explain that CK MB is an enzyme which is mainly found in the heart and brain. But, it can also be found in other muscles.

So, a slight increase in CK MB may be also related to physical exertion, especially when troponin levels are negative.

As long as troponin levels have resulted normal and there were no ECG changes, there is no reason to worry about any heart attack or any other kind of heart damage.

These CK MB levels are borderline and they may be attributed just to physical activity or a musculoskeletal pain.

Anyway, if you experience recurrent chest pain during physical exertion, I would recommend performing an exercise cardiac stress test in order to investigate for possible coronary artery disease.

Hope you will find this answer helpful!

I remain at your disposal for any further questions whenever you need!

Kind regards,

Dr.Ilir Sharka, Cardiologist


Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ilir Sharka (2 hours later)
Hello,


Thank you for the reply. Could the low blood sugar have elevated the CK-MB? There was no physical exertion at the time. My heart rate was super high and I had chest pain along with a blood sugar of 34. Of course I get tachycardia whenever my blood sugar drops.
doctor
Answered by Dr. Ilir Sharka (9 hours later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again!

Regarding your concern, I would explain that there are many studies in the medical literature, which show that low blood sugar (hypoglycemia) can induce increase CK and CK MB levels, due to muscle damage from the low glucose levels, as such low glucose levels induce stress to the muscles, which need glucose to work properly.

So, I think that high CK MB can also be explained with the low blood sugar levels.

Hope you will find this information helpful!

Wishing all the best,

Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9535 Questions

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In 2012, I Called 911 With Chest Pain And Low

Brief Answer: I would explain as follows: Detailed Answer: Hello! Welcome to Ask a Doctor service! Regarding your concern, I would explain that CK MB is an enzyme which is mainly found in the heart and brain. But, it can also be found in other muscles. So, a slight increase in CK MB may be also related to physical exertion, especially when troponin levels are negative. As long as troponin levels have resulted normal and there were no ECG changes, there is no reason to worry about any heart attack or any other kind of heart damage. These CK MB levels are borderline and they may be attributed just to physical activity or a musculoskeletal pain. Anyway, if you experience recurrent chest pain during physical exertion, I would recommend performing an exercise cardiac stress test in order to investigate for possible coronary artery disease. Hope you will find this answer helpful! I remain at your disposal for any further questions whenever you need! Kind regards, Dr.Ilir Sharka, Cardiologist