[Soul]

So its not a typo error neither a lab error. Actually there are cases of AMI where CK was normal but CK-MB was highly elevated, but in this case troponin is also negative. Could it be due to early measurement of cardiac enzymes (2 hrs), coz neither CK nor troponin would be detected under 2 hours of presentation (if it is a case of AMI). I guess CK-MB having slightly lower molecular weight can be detected earlier than CK. But CK-MB value is too high which makes more confusion.

Is prostatism the culprit? TURP can lead to increase in CK-MB alone (some studies showed no rise in CK, but highly elevated level of CK-MB after TURP), but no H/O TURP in this case. I don't know whether prostatism alone can cause increase in CK-MB, not CK.

Sorry I couldn't figure out the Dx. Since CK-MB is high, MI can not be ruled out. I would repeat ECG and look for 'dongtai gaibian' and biomarker test and treat for Non-STEMI. If no changes in ECG and troponin after few hours, then MI could be ruled out and look for other causes.

Looking for the answer.