Postoperative real-time electrocardiography monitoring detects myocardial ischemia: a case report

Purpose This case report outlines the utility and challenges of remote continuous postoperative electrocardiography ECG) monitoring, which is routed through a secure smartphone to provide real-time detection and management of myocardial ischemia. Clinical features A 42-yr-old male with previous myoc...

Full description

Saved in:
Bibliographic Details
Published in:Canadian journal of anesthesia 2017-04, Vol.64 (4), p.411-415
Main Authors: Yang, Homer, Fayad, Ashraf, Chaput, Alan, Oake, Stuart, Chan, Adrian D. C., Crossan, Mary Lou
Format: Article
Language:English
Subjects:
Adult
Anesthesia
Anesthesiology
Angioplasty
Blood pressure
Cardiology
Case Reports
Case Series
Computer Systems
Critical Care Medicine
Electrocardiography
Electrocardiography - methods
Fentanyl
Heart attacks
Heart rate
Hospitals
Humans
Intensive
Ischemia
Male
Medicine
Medicine & Public Health
Monitoring, Physiologic - instrumentation
Monitoring, Physiologic - methods
Myocardial Ischemia - diagnosis
Pain Medicine
Patients
Pediatrics
Pneumology/Respiratory System
Postoperative Care - methods
Postoperative Complications - diagnosis
Pulse oximetry
Real time
Smartphone
Smartphones
Surgery
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Purpose This case report outlines the utility and challenges of remote continuous postoperative electrocardiography ECG) monitoring, which is routed through a secure smartphone to provide real-time detection and management of myocardial ischemia. Clinical features A 42-yr-old male with previous myocardial infarction and angioplasty underwent a radical prostatectomy. At three hours and 45 min postoperatively, remote real-time ECG monitoring was initiated upon the patient’s arrival on a regular surgical ward. Monitor alerts were routed to a study clinician’s smartphone. About six hours postoperatively, alarms were received and horizontal ST segment depressions were observed. A 12-lead ECG validated the ST segment changes, prompting initiation of a metoprolol iv and a red blood cell transfusion. Approximately seven hours and 30 min postoperatively, the ST segments normalized. The patient was discharged on postoperative day 3 and followed for four years without any sequelae. Conclusion This case report illustrates the use of remote ECG monitoring and clinician response in real time with the use of a smartphone. With each alert, a small ECG strip is transmitted to the smartphone for viewing. In our view, this technology and management system provides a possible means to interrupt myocardial ischemic cascades in real time and prevent postoperative myocardial infarction.
ISSN:0832-610X
1496-8975
DOI:10.1007/s12630-017-0817-0