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[Three cases with electrocardiographic changes suggesting myocardial infarction]
C Takanami1, K Nakajima, K Aso
1Department of Anesthesiology, Fukui Medical School.
Insights
Elderly patients undergoing abdominal surgery may experience reversible myocardial infarction, presenting with electrocardiographic changes but lacking typical enzyme or autopsy findings. This suggests a distinct clinical entity requiring further investigation.
Area of Science:
- Cardiology
- Geriatric Medicine
- Surgical Oncology
Background:
- Myocardial infarction (MI) can occur perioperatively, especially in elderly patients with complex conditions.
- Typical MI diagnosis relies on electrocardiographic (ECG) changes, elevated myocardial enzymes, and autopsy findings.
- Previous research suggests 'reversible myocardial infarction' may occur in elderly patients undergoing surgery.
Abstract:
We had three cases that showed electrocardiographic changes suggesting myocardial infarction during or soon after operation. All cases were elderly for open abdominal operation complicated with carcinoma or infection. They were different from typical myocardial infarction in progress of electrocardiographic changes, increase of myocardial enzyme, autopsy and so on. Kuramoto et al. reported in some cases myocardial infarction could not be recognized at autopsy in spite of electrocardiographic changes suggesting myocardial infarction during gastric operation of the elderly, and they advocated an idea of "reversible myocardial infarction". These three cases were also thought to be consistent with this disorder.