Postoperative electrocardiographic modifications. A study of 260 operated cases

On 260 patients (98 males and 162 females ranging in age from 18 To 68 years) operated for 41 different alTeclions of general surgery of which Ihe preoperative cardio logic examination was negative, electrocardiograms were taken before and after the Operation (between the 5th and 10th postoperative day). Preoperatively 238 patients had normal ECG and the remaining Tl abnormal. 52 (20%) of the 238 patients with normal ECG, showed abnormal postoperative ECG. 18 of the 22 pathological preoperative EGG remained unchanged postoperatively. The other 4 patients presented additional postoperative electrocardiographic modifications. The two thirds of the patients with abnormal postoperative ECG were younger than 50 years old. The modifications found on 74 abnormal postoperative ECG were the following by order of frequency: 1) Subepicardial ischemia, 2) extrasystoles 3) negative T waves in V2, 4) sitbentith cardial lesion, 5) left bundle branch block, 6) right bundle branch block, 7) auricular fibrillation, 8) left ventrictdar strain, it) long QT interval, 10) short QT interval.The authors attribute these pathologic modifications to impaired myocardial circulation and a myocardial lesion probably due to the stagnation of the blood in the different regions of the body, to the influence on the central or vegetative nervous system, to the variations of electrolytes of the blood serum, and to 1% of the cases to possible pulmonary embolism.In conclusion, the authors wish to emphasize the advantages of a thorough clinical, fluoroscopic and electrocardiographic preoperative examination by the cardiologist in combination with the preanesthetic examination of the anesthesiologist.Thus, the prevention of a part of hearl complications, which may develop during the postoperative period of the operated on patients, is rendered possible. © 1959 S. Karger AG, Basel