An 85 year old man has a fall at home and is seen in the Emergency Department. He had incontinence of urine and had been lying on the floor all night. He had a myocardial infarction 8 years ago. He takes aspirin, atorvastatin and ramipril.
His pulse rate is 94 bpm and BP 106/76 mmHg.
- White cell count 14.3 × 10⁹/L (3.0–11.0)
- Urea 30.4 mmol/L (2.5–7.8)
- Creatinine 158 micromol/L (60–120)
- Creatinine kinase 11025 U/L (25–200)
ECG: Q waves in lead III.
Which is the most likely cause of his raised creatinine kinase?
- Acute kidney injury
- Acute myocardial infarction
- Urinary tract infection