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Cardiac enzymes in patients undergoing caesarean section
Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|January 1, 1995
Summary
Chest pain and ECG changes during Caesarean delivery may not indicate myocardial infarction. Studies show cardiac enzyme CK-MB levels remain negative, suggesting no heart muscle injury in parturients.
Area of Science:
- Cardiology
- Obstetrics
- Anesthesiology
Background:
- Electrocardiogram (ECG) changes in parturients during Caesarean section can mimic myocardial ischemia.
- Chest pain, discomfort, and ST-segment depression are observed in some patients.
Purpose of the Study:
- To determine serum creatine kinase (CK) total and CK-MB isoenzyme levels in parturients undergoing Caesarean delivery.
- To investigate the correlation between ECG changes and cardiac enzyme levels.
Main Methods:
- Serum CK total and CK-MB levels were measured in 21 patients during and after Caesarean section under epidural anesthesia.
- ECG findings and patient-reported symptoms were recorded.
Main Results:
- Twenty patients reported chest pain, discomfort, or pressure.
- Twelve patients exhibited ST-segment depression on ECG.
- Elevated total CK activity was noted in ten patients, but CK-MB activity was negative in all patients.
- ECG changes were associated with surgical pressure and heart rate, not myocardial injury.
Conclusions:
- Despite chest pain and ECG abnormalities, myocardial injury, as indicated by negative CK-MB levels, does not occur in parturients undergoing Caesarean delivery.
- ECG changes are likely rate-related and secondary to surgical manipulation rather than acute coronary events.