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Arrythmias and ischemic changes of the heart induced by gastric endoscopic procedures
Insights
Endoscopy can cause heart rhythm changes in patients with cardiovascular disease, including premature beats and atrial fibrillation. Propranolol effectively prevented heart rate changes during the procedure.
Area of Science:
- Cardiology
- Gastroenterology
Background:
- Cardiovascular disease patients may experience physiological changes during endoscopic procedures.
- Understanding these changes is crucial for patient safety.
Purpose of the Study:
- To investigate cardiovascular and electrocardiographic (ECG) changes during upper gastrointestinal endoscopy.
- To assess the efficacy of propranolol in mitigating these changes.
Main Methods:
- Studied 59 cardiovascular disease patients and 27 controls undergoing endoscopy.
- Monitored heart rate, blood pressure, and ECG.
- Administered 2 mg propranolol intravenously in some cases.
Main Results:
- Arrhythmias like premature beats and atrial fibrillation were observed.
- ST-T changes were common in ischemic and valvular heart disease groups.
- Propranolol effectively prevented heart rate changes.
Conclusions:
- Endoscopy can induce significant cardiovascular changes in susceptible patients.
- Early intervention with propranolol may be beneficial for managing heart rate fluctuations.
Abstract:
Changes in the heart rate, blood pressure, ECG, occurring at the time of endoscopy of the stomach were studied in a group of 59 cases of cardiovascular disease and in a control group of 27 cases. With regard to arrythmias appearing at the time of endoscopy of the stomach, ventricular and atrial premature beats were the most numerous. Atrial fibrillation, as well as ventricular bigeminy were encountered. Two cases of atrial fibrillation continued even after the end of the examination. ST-T changes during endoscopy were found most frequently in the ischemic heart disease group and the valvular heart disease group. There were three cases in which severe ST depression made it necessary to stop the examination. The cardiovascular changes generally occurred at the beginning of the endoscopy examination. Two milligrams of propranolol i.v. seemed to be effective in preventing changes of heart rate.