Document Detail

A case presenting with myocardial ischemia-like electrocardiogram findings after laryngopharyngoesophagectomy.
MedLine Citation:
PMID:  17294675     Owner:  NLM     Status:  MEDLINE    
Laryngopharyngoesophagectomy and reconstruction by using stomach roll with retrocardiac anastomosis were performed in a 60-year-old man with hypopharyngeal cancer. Postoperative electrocardiogram showed marked ST-segment elevation in leads I and aVL and depression in leads II, III, aVF, and V1-6. However, the patient did not present with abnormal findings on physical examination and vital signs were normal. Further, the laboratory data were normal. Echocardiography was a poor technique, but the stomach roll was observed to be expanded due to wall edema with exudates and exerted pressure on the posterior side of the heart. These findings were also ascertained by contrast-enhanced chest computed tomography scanning. Technetium-99m-tetrofosmin myocardial scintigraphy clearly showed that coronary blood perfusion and left ventricular wall motion were quite normal. The characteristic electrocardiogram returned to a near-normal state, and the expanded stomach roll shrank back to its ordinary size after one week. Coronary angiography showed neither organic stenoses nor vasospasm. The physical pressure of the expanded stomach roll might have influenced the electrocardiogram findings.
Ritsuko Nakano; Kan Zen; Tetsuhiro Yamano; Takahisa Sawada; Akihiro Azuma; Hiroaki Matsubara
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Annals of nuclear medicine     Volume:  20     ISSN:  0914-7187     ISO Abbreviation:  Ann Nucl Med     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2007-02-13     Completed Date:  2007-03-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8913398     Medline TA:  Ann Nucl Med     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  633-7     Citation Subset:  IM    
Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine.
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MeSH Terms
Contrast Media / pharmacology
Coronary Angiography / methods
Electrocardiography / methods*
Esophagus / pathology,  surgery*
Middle Aged
Myocardial Infarction / diagnosis
Myocardial Ischemia / diagnosis*
Organophosphorus Compounds / pharmacology
Organotechnetium Compounds / pharmacology
Stomach / pathology
Tomography, Emission-Computed, Single-Photon / methods*
Tomography, X-Ray Computed / methods
Reg. No./Substance:
0/Contrast Media; 0/Organophosphorus Compounds; 0/Organotechnetium Compounds; 0/technetium Tc 99m 1,2-bis(bis(2-ethoxyethyl)phosphino)ethane

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