Cardiac ischaemia and rhythm disturbances during elective colonoscopy
A T George1, C Davis1, A Rangaraj1
1Department of General Surgery, The Royal Gwent Hospital, Newport, South Wales, UK.
Frontline Gastroenterology
|August 26, 2017
Summary
Elective colonoscopy can cause silent cardiac rhythm disturbances and ischemia in patients with heart disease or risk factors. Monitoring is crucial for these individuals undergoing the procedure.
Area of Science:
- Cardiology
- Gastroenterology
- Medical Procedures
Background:
- Colonoscopy use is increasing due to widespread bowel screening programs.
- This rise necessitates understanding potential risks associated with the procedure.
Purpose of the Study:
- To investigate if elective colonoscopy can trigger cardiac rhythm disturbances.
- To assess for myocardial ischemia using ECG and troponin I levels.
Main Methods:
- Patients were grouped by cardiac disease presence or cardiovascular risk factors.
- 12-lead Holter ECG monitoring was performed before, during, and after colonoscopy.
- Cardiac troponin I (cTnI) levels were measured pre- and post-procedure.
Main Results:
- High incidence of new, silent ischemic and arrhythmic ECG changes observed during colonoscopy.
- These changes were most prominent in patients with stable heart disease, and less so in those with risk factors.
- Elevated cTnI levels were noted in three patients; two patients with known heart disease died within 30 days.
Conclusions:
- Elective colonoscopy can induce clinically significant ST-T wave changes and rhythm disturbances.
- These events occur in patients with known heart disease and those with cardiovascular risk profiles.
- The findings highlight the importance of cardiac monitoring during colonoscopy for at-risk populations.
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