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Open Access

Electrocardiographic disturbances after cardiac surgery in patients with coronary disease

  • HP Guimarães1,
  • RD Lopes1,
  • MPF Costa1,
  • PHR Leal1,
  • AP Resque1,
  • F Freitas1,
  • LO Bueno1,
  • FR Machado1 and
  • JLG Amaral1
Critical Care20059(Suppl 2):P6

https://doi.org/10.1186/cc3550

Published: 9 June 2005

Keywords

Coronary Artery Bypass GraftMyocardial IschemiaDobutamineArtery Bypass GraftSupraventricular Tachycardia

Introduction

The risk of major cardiovascular events in the postoperative period can reach up to 25%, particularly if there were CAD antecedents.

Methods

A prospective study in patients with CAD diagnosed by complementary examination (arteriography) or clinical history (MI, angina), monitored in the first 24 hours of the postoperative period, using the system of continuous electrocardiography monitoring (Holter®) of three canals and myocardial injury markers (CPK, MB and troponin).

Results

Initial inclusions involved seven (70%) male patients and three (30%) female patients; the age varied from 48 to 90 years, with an average of 66 years and a mode of 56 years. The APACHE varied score from 4 to 14 with a mode of 14, and the median risk of death was 5%. Three patients (30%) had antecedents of coronary artery bypass graft and three (30%) patients of angioplasty; four patients had recent coronary arteriography with injuries of up to 60% in up to two cases. Arrhythmias had been present in all the patients, being supraventricular extrasystole and supraventricular tachycardia in five (50%) patients and ventricular extrasystole in five (50%) patients. Three (30%) patients had presented silent myocardial ischemia with disturbances in the ST segment varying from 2.0 to 3.4 mm in at least two canals, with positive trooping in two (20%) patients, although an echocardiogram of stress with dobutamine (previous to surgery) was negatively affected in two of these patients. We did not have death occurrence, having only prolongation of hospital internment in the three patients with myocardial ischemia.

Conclusion

The occurrence of myocardial ischemia in patients with CAD can be a frequent event and, despite evaluation daily post surgery, must always rigorously be monitored.

Authors’ Affiliations

(1)
Federal University of São Paulo, UNIFESP, EPM, São Paulo, Brazil
(2)
São Camilo University Center, São Paulo, Brazil

References

  1. Guimarães HP, et al.: Alterações Eletrocardiográficas Durante a Retirada da Ventilação Mecânica: Resultados iniciais da Monitoração Eletrocardiográfica Contínua (Holter ® ). Rev Brasil Terapia Intensiva 2002,99(suppl 1):P423.Google Scholar

Copyright

© BioMed Central Ltd 2005

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