Creatine kinase 20,000 U/L is very high, which means that muscle damage is more serious. Consider myocardial infarction or severe rhabdomyolysis from myocardial injury, such as rhabdomyolysis after oral statins or myocardial injury from drug application, both of which can have severe myokinase elevations, and attention must be paid to finding the cause. Some patients may also have elevated myoenzymes due to strenuous exercise, which is caused by muscle damage, or severe liver function impairment, which may also result in elevated myoenzymes. If the elevated myokinase is due to conditions such as myocardial infarction or rhabdomyolysis, 20,000 U/L is very dangerous and must be treated further, if necessary with blood purification to improve the elevated creatine kinase process. In case of myocardial infarction, it is important to improve myocardial ischemia in a timely manner. The elevation of myokinase that occurs with severe exercise is determined by the severity of the patient’s specific injury.