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Stress response to endoscopy.

H Tønnesen1, L Puggaard, J Braagaard

  • 1Dept. of Surgical Gastroenterology, University of Copenhagen, Herlev Hospital, Denmark.

Scandinavian Journal of Gastroenterology
|August 10, 1999
PubMed
Summary
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Upper gastrointestinal endoscopy can cause tachycardia due to an endocrine stress response. This study found increased norepinephrine and cortisol levels during the procedure, explaining the elevated heart rate in patients undergoing gastroscopy.

Area of Science:

  • Gastroenterology
  • Endocrinology
  • Cardiology

Background:

  • Upper gastrointestinal endoscopy is frequently associated with tachycardia.
  • The underlying cause of this tachycardia remains unclear, but endocrine stress responses may play a role.

Purpose of the Study:

  • To investigate the endocrine and metabolic stress response during upper gastrointestinal endoscopy.
  • To determine the relationship between this stress response and the observed tachycardia.

Main Methods:

  • Seventeen patients undergoing diagnostic gastroscopy without sedation were monitored for heart rate, blood pressure, and oxygen saturation.
  • Blood samples were analyzed for glucose, cortisol, epinephrine, and norepinephrine levels before, during, and after endoscopy.
  • Pre-procedure anxiety levels were assessed.

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Main Results:

  • Endoscopy led to significant increases in norepinephrine and cortisol levels, accompanied by elevated heart rate and mean arterial blood pressure.
  • Epinephrine levels decreased post-procedure, while glucose and oxygen saturation remained unchanged.
  • No signs of myocardial ischemia were observed, and pre-procedure anxiety did not correlate with stress markers.

Conclusions:

  • Upper gastrointestinal endoscopy triggers a classic endocrine metabolic stress response.
  • This stress response is likely responsible for the tachycardia observed during the procedure.