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ECG changes during endoscopic retrograde cholangio-pancreatography and coronary artery disease

Merete Christensen1, Thor Milland, Verner Rasmussen

  • 1Department of Surgery and Holter Lab, Hvidovre University Hospital, Hvidovre, Denmark. merete.christensen@dadlnet.dk

Scandinavian Journal of Gastroenterology
|July 23, 2005
PubMed

Insights

Endoscopic retrograde cholangio-pancreatography (ERCP) can cause myocardial ischemia, but coronary artery disease is not the cause. Further research is needed to understand the mechanisms of ischemia during ERCP.

Area of Science:

  • Cardiology
  • Gastroenterology
  • Medical Procedures

Background:

  • Myocardial ischemia has been observed during Endoscopic Retrograde Cholangio-Pancreatography (ERCP).
  • The underlying mechanisms causing myocardial ischemia during ERCP are not fully understood.

Purpose of the Study:

  • To investigate the presence of coronary artery disease (CAD) in patients experiencing ST-segment changes during ERCP.
  • To determine if pre-existing CAD is a contributing factor to ERCP-induced myocardial ischemia.

Main Methods:

  • Forty patients undergoing ERCP were monitored using Holter tape recorders.
  • Patients with ST-segment deviation during ERCP underwent standard exercise electrocardiogram (ECG) testing.
  • Coronary angiography was performed in select cases.

Main Results:

  • Twelve patients (30%) exhibited signs of myocardial ischemia during ERCP, with nine experiencing tachycardia.
  • None of the affected patients had a prior cardiac history or symptoms.
  • Exercise ECG and coronary angiography revealed no evidence of significant coronary artery disease in patients with ERCP-induced ST deviation.

Conclusions:

  • Existing coronary artery disease is unlikely to be the cause of ST deviation and myocardial ischemia during ERCP.
  • Further investigation into alternative mechanisms is warranted to explain myocardial ischemia during ERCP.
Abstract

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