Question
My dad has RA and has had it under control for over 6 years now.  Last easter he was having trouble breathing and he thought he had pneumonia.  He went to the doctor only to find out it was closed due to the holiday.(Good Friday) His Dr's office is across the street from the ER so he went in and gave them his symptoms and the did some tests.  They came back and they told him he had a heart attack.  He said how do you figure, because he said he had nono of the stereotypical symptomys, the guy said that your blood work showed us you did.  My question is, ( I am just starting Nursing school, so I am very eager to learn, especially when it comes to my family)  
Question:
Is it possible for the CPK enzyme to have been in his blood due to the damaging effects of his RA?

Actually the first rheumatologist he had said that sometimes test might show he had a heart attack, and to be sure he told them he had rheumatoid arthritis.  I asked my dad if he did, and he said they could look at my hands and see...  This is not always the case, ER's a busy and they may not have even thought to ask him his history.  Any information you may have will be greatly appreciated.  He is still taking beta blockers and if he doesn't need to be then that would be great!!!

Answer
Amanda,

Very good question. CPK is not something you see with RA. There are other conditions that can raise your CPK level besides heart related conditions such as

   * Central nervous system trauma or stroke
   * Convulsions
   * Delirium tremens
   * Dermatomyositis or polymyositis
   * Electric shock
   * Muscular dystrophies
   * Pulmonary infarction (lung tissue death)

This can be confusing because some of the test used to diagnose a heart attack are also used to diagnose RA. C Reactive Protein (CRP)is one of them and Erythrocyte Sedimentation Rate (ESR)is another.

You are right to make sure your father mentions that he has RA when being seen by a new doctor. It is highly possible to be diagnosed whigh a heart attack when you have chest pain and your CRP and ESR are high, when in fact they are high because of a persons RA.

After 6 months, your father can talk to his doctor or cardiologist about whether there is a need to continue taking beta blockers. If his blood pressure is fine and all of his blood work is normal it is possible that the doctor will not see a need to continue.

Rusty
http://arthritis-symptom.com/Rheumatoid-arthritis-symptoms/index.htm