Non-kardiak hastalarda elektrokardiografik değişiklikler

Abstract

Transient electrocardiographic changes in patients with acute cholecystitis, pancreatitis, pneumonia and septic shock have been reported in the past 70 years. These changes usually are in the form of T-wave inversion, ST-segment depression, and rarely ST segment elevation in the absence of coronary heart disease. A vagally mediated cardio-biliary reflex is the presu-med cause of these changes. Three cases was diagnosed as acute cohlecystitis, acute pancreatitis and septic shock presented with literature as a review. The signs and symtomps of gallbladder and heart disease may overlap, making diagnosis diffucult. In patients with known coronary heart disease and acute cholecystitis, the surgeon shouldn't be discouraged from cholecystektomi merely because of questionable electrocardiogram. Undue delay in treatment while awaiting the result of the cardiac screen may result in both cardiac and septic complications. Dopamine and dobutamine infusion induced coronary vasoconstriction should be use carefully in patients with septic shock.