Incidence of electrocardiographic changes during cesarean delivery under regional anesthesia

Serial electrocardiograms were obtained on 93 healthy ASA physical status I and II term parturients during nonemergent cesarean delivery under regional anesthesia. Electrocardiographic changes occurred in 44 of the 93 patients (47.3%); in 35 of these 44 patients, the changes were characteristic, or suggestive, of myocardial ischemia. Symptoms of chest pain, pressure, and dyspnea occurred in 15 of the 44 patients with electrocardiographic changes; no patient without electrocardiographic change developed symptoms of chest pain, pressure, or dyspnea. Small but statistically significant differences were noted in heart rate, diastolic and systolic arterial pressures, and rate-pressure product between the patients with electrocardiographic changes and those without. The authors speculate that myocardial ischemia is a likely cause of both the electrocardiographic changes seen in these patients and of the symptoms of chest pain and dyspnea that they sometimes experience.