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Endoscopic retrograde cholangiopancreatography causes reduced myocardial blood flow

M Christensen1, H W Hendel, V Rasmussen

  • 1Department of Surgical Gastroenterology, Hvidovre University Hospital, Hvidovre, Denmark. merete.Christensen@dadlnet.dk

Endoscopy
|September 24, 2002
PubMed

Insights

Endoscopic retrograde cholangiopancreatography (ERCP) may cause myocardial ischemia, indicated by reduced blood flow. This study suggests alternative diagnostic methods for the biliary tree and pancreas due to potential cardiac risks during ERCP.

Area of Science:

  • Cardiology
  • Gastroenterology
  • Diagnostic Imaging

Background:

  • Previous research indicates ST-segment changes in up to 50% of patients during upper gastrointestinal endoscopy.
  • Endoscopic retrograde cholangiopancreatography (ERCP) is an established procedure for evaluating the biliary tree and pancreatic duct.

Purpose of the Study:

  • To assess myocardial blood flow in patients undergoing ERCP.
  • To determine if ERCP procedures induce myocardial ischemia.

Main Methods:

  • 11 patients undergoing ERCP were enrolled.
  • Continuous Holter tape monitoring and myocardial perfusion scintigraphy were used.
  • Myocardial perfusion was evaluated at rest and during the ERCP procedure.

Main Results:

  • Ten patients completed the study.
  • Two out of ten patients exhibited signs of myocardial ischemia during ERCP.
  • Ischemia was detected by both Holter monitoring and myocardial scintigraphy (P = 0.02).

Conclusions:

  • ERCP can lead to true myocardial ischemia and reduced myocardial blood flow.
  • Findings suggest considering alternative diagnostic approaches for pancreatic and biliary evaluation.
  • Further research is warranted, but results highlight potential cardiac implications of ERCP.
Abstract

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