A case presenting with myocardial ischemia-like electrocardiogram findings after laryngopharyngoesophagectomy

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. Ho...

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Bibliographic Details
Published in:Annals of nuclear medicine 2006-11, Vol.20 (9), p.633-637
Main Authors: Nakano, Ritsuko, Zen, Kan, Yamano, Tetsuhiro, Sawada, Takahisa, Azuma, Akihiro, Matsubara, Hiroaki
Format: Article
Language:English
Subjects:
Contrast Media - pharmacology
Coronary Angiography - methods
Echocardiography
Electrocardiography - methods
Esophagus - pathology
Esophagus - surgery
Humans
Medical diagnosis
Medical imaging
Middle Aged
Movement
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
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Summary: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.
ISSN:0914-7187
1864-6433
DOI:10.1007/BF02984662