Author + information
- Miraç Vural1,
- Serkan Bulur2,
- Osman Köstek1,
- Berrin Erok3,
- Orçun Can1,
- Yavuz Onur Danacıoğlu4 and
- Aytekin Oğuz1
Perioperative myocardial infarction (MI) is associated with high mortality rates in patients undergoing non cardiac surgery. It is difficult to diagnose perioperative MI because it often can not be described due to typical analgesics. Therefore, the diagnosis of perioperative MI can be detected by changes in ECG and troponin.
One hundred and one patients (39 female; mean age 72±11 years) whose Framingham General Cardiovascular Disease Risk Score between 10% and 47% were included. ECG records and troponin measurements were performed in preoperative assessment and repeated at the second postoperative day. Troponin levels above 0,04 ng/mL were considered to be significant.
Postoperative ECG changes were detected in 39 patients and also significantly elevated troponin levels were measured in 19 patients. Both ischemic ECG changes (>0.5 mm ST depression or negative T wave) and significantly elevated troponin (>0.04 ng/dl) levels were detected together in 6 patients. There was no postoperative typical angina. The most common postoperative ECG changes were ST depression (11 patients). Then, atrial extra systole (7 patients), sinus tachycardia (6 patients), negative T wave (6 patients), ventricular extra systole (4 patients), new-onset atrial fibrillation (2 patients) and left bundle branch block (1 patient) and right bundle branch block (1 patient), supraventricular tachycardia (1 patient) were detected respectively.
Patients with intermediate to high risk groups according to Framingham General Cardiovascular Disease Risc Score have frequently ischemic changes during postoperative period of non cardiac surgery. This condition may be associated with perioperative cardiac morbidity and mortality.
Keywords: non cardiac surgery, electrocardiogram, troponin, framingham risc score.