Abstract:
:Because acute segmental wall motion abnormalities (SWMAs) of the left ventricle are highly sensitive and specific indicators of myocardial ischemia, this study compared the incidence and significance of ischemia, as detected by two-dimensional transesophageal echocardiography and surface electrocardiography, during anesthesia and surgery in patients at high risk of myocardial ischemia. During surgery, 24 of the 50 patients studied had new SWMAs, whereas only six had ST segment changes. All patients with ST segment changes also had new SWMAs: in three instances, SWMAs occurred before the ST segment change, and in three instances, they occurred simultaneously. All three patients who had intraoperative myocardial infarctions also had persistent intraoperative SWMAs, whereas only one patient had ST segment changes. Ten healthy patients requiring noncardiovascular surgery were monitored similarly; none of these had SWMAs, ST segment changes, or myocardial infarction. This study demonstrates the superiority of two-dimensional transesophageal echocardiography over electrocardiography for the intraoperative detection of myocardial ischemia. Furthermore, when new SWMAs persist to the conclusion of surgery, myocardial infarction is likely to have occurred.
journal_name
Circulationjournal_title
Circulationauthors
Smith JS,Cahalan MK,Benefiel DJ,Byrd BF,Lurz FW,Shapiro WA,Roizen MF,Bouchard A,Schiller NBdoi
10.1161/01.cir.72.5.1015subject
Has Abstractpub_date
1985-11-01 00:00:00pages
1015-21issue
5eissn
0009-7322issn
1524-4539journal_volume
72pub_type
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