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SILENT MYOCARDIAL ISCHEMIA IN HEMODIALYSIS PATIENTS - FACTOR FICTION?

A S Narula1, H S Bali2, V Sakhuja3

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Summary
This summary is machine-generated.

Hemodialysis can cause myocardial ischemia, indicated by ST segment changes on electrocardiograms (ECG). This study found that nearly half of patients undergoing hemodialysis experienced these cardiac events.

Keywords:
Holter monitoringIschemic heart diseaseRenal dialysis

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Area of Science:

  • Cardiology
  • Nephrology
  • Medical Monitoring

Background:

  • Myocardial ischemia can manifest as ST segment changes on an electrocardiogram (ECG).
  • Holter monitoring is a standard tool for detecting dynamic ECG abnormalities over extended periods.

Purpose of the Study:

  • To investigate the incidence of myocardial ischemia, identified by ST segment changes, during and between hemodialysis sessions.
  • To determine the role of hemodialysis in the development of these ECG changes.

Main Methods:

  • Thirty-eight patients underwent 48-hour Holter ECG monitoring.
  • Monitoring covered both the hemodialysis period and the intermediate period.
  • ST segment changes were analyzed for incidence, duration, and severity.

Main Results:

  • 17 patients (44.7%) experienced 165 episodes of dynamic ST segment changes, with durations up to 177 minutes and ST depression up to 4 mm.
  • The affected patient group had a mean age of 45 ± 14 years, with 82.6% males, and common comorbidities including hypertension, diabetes mellitus, and coronary artery disease.
  • Ventricular ectopics, including ventricular tachycardia, were observed in 35.3% of patients with ST changes. No significant hypotension or angina was reported during these episodes.

Conclusions:

  • Hemodialysis is a significant factor in the occurrence of ST segment changes suggestive of myocardial ischemia.
  • The study highlights the importance of cardiac monitoring in patients undergoing hemodialysis, even in the absence of typical ischemic symptoms.