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Related Experiment Videos

Unexpected ST segment changes in children--a case report.

Andrej Alfirevic1, Emad Mossad, Julie Niezgoda

  • 1Division of Anesthesiology and Critical Care Medicine, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA.

Paediatric Anaesthesia
|January 15, 2005
PubMed
Summary

Myocardial ischemic changes are rare in healthy children during anesthesia. A case report highlights pulmonary arteriovenous fistula as a potential cause of hypoxemia and paradoxical embolism.

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Area of Science:

  • Pediatric Anesthesiology
  • Cardiology
  • Pulmonology

Background:

  • Myocardial ischemic changes during anesthesia are uncommon in children without pre-existing conditions.
  • This case involves a healthy child undergoing adenoidectomy and bilateral tympanostomy.

Observation:

  • The patient exhibited significant ST changes and experienced intraoperative and postoperative hypoxemia.
  • Echocardiography suggested intrapulmonary right to left shunting.

Findings:

  • Pulmonary arteriovenous fistula is suspected as the primary cause of hypoxemia and paradoxical air embolism during positive pressure ventilation.
  • Anomalous coronary artery origin is also considered as a potential cause for ST segment changes.

Implications:

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  • Further diagnostic work-up is crucial to rule out underlying pathologies, even if initially inconclusive.
  • Long-term follow-up is essential for understanding these potentially fatal, often subclinical conditions.