[Examination of cardiovascular parameters and plasma free fatty acids during esophago-gastro-duodenoscopy (author's...

53 patients were examined for changes of blood pressure, heart rate, ECG and plasma free fatty acids during esophago-gastro-duodenoscopy. In 23 cases there were premature contractions, occuring in small numbers only in most of the cases. Only in 5 cases there was an accumulation of premature contractions and in one case ventricular bigeminism occurred. The maximum of premature beats was observed when the primarily sitting patient was put into supine position. In 7 patients there was a lowering of the ST-segment in the ECG by at least 0.1 mV, mostly in patients who already had an abnormal ST-segment before endoscopy. The pulse rate went up by an average of 50.1 per cent, the systolic blood pressure by 14 and the diastolic blood pressure by 17 per cent. The increase of plasma free fatty acids in the total patient material was not statistically significant, but patients with a deterioration of ECG-findings endoscopy had a significantly higher increase of plasma free fatty acids. There was a tendency towards a positive correlation between the number of premature beats and the increase of plasma free fatty acids. It cannot be decided from our study whether the mobilization of free fatty acids is causing the above observed increase of premature beats or whether both phenomena are merely a result of sympathetic nervous stimulation. Gastric fiberoscopy may be applied to elderly patients with decreased cardiac function. The endoscopic procedure should not be started on the sitting patient but primarily in left supine position.