A Mysterious Case of Acute T Wave Inversion at Anesthesia Induction: A Case Report
Lola Del Puppo1, Soraya Bicher1, Roxane Fournier1
1From the Departments of Anaesthesiology.
Insights
Isolated T-wave inversion on electrocardiogram (ECG) monitoring during surgery may not indicate myocardial ischemia. This case shows that persistent ECG changes without elevated troponin warrant cautious interpretation to prevent unnecessary investigations.
Area of Science:
- Cardiology
- Anesthesiology
- Medical Diagnostics
Background:
- Perioperative myocardial ischemia is a significant concern impacting patient outcomes.
- Continuous electrocardiogram (ECG) monitoring is standard during anesthesia.
- Routine troponin screening aids in diagnosing myocardial injury.
Abstract:
Detection and management of suspected intraoperative myocardial ischemia are critical for patient outcome. Following induction of general anesthesia, sudden global T-wave inversion appeared on continuous electrocardiogram (ECG) monitoring, raising suspicion for acute myocardial ischemia and prompting cancellation of surgery. The patient underwent a thorough evaluation for myocardial ischemia despite negative circulating troponin, but all tests were negative. The T-wave inversion persisted for 2 months. This case highlights the need for caution in interpreting isolated perioperative ECG changes in the era of heightened awareness for perioperative myocardial ischemia and routine troponin screening, to avoid unnecessary and potentially invasive investigations.
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