Electrocardiographic Changes Following Gastric Surgery with Special Reference to the Blood Transfusion

• Published in: Nihon Rōnen Igakkai zasshi Vol. 14; no. 4; pp. 245 - 252
• Main Authors: Kanazawa, Kyotaro, Murakami, Mototaka, Kuwako, Kenji, Matsushita, Satoru, Kuramoto, Kizuku
• Format: Journal Article
• Language: Japanese
• Published: Japan The Japan Geriatrics Society 01.07.1977
• Subjects: Aged; Blood Transfusion; Electrocardiography; Female; Gastrectomy; Humans; Male; Middle Aged; Stomach Neoplasms - surgery; Stomach Ulcer - surgery
• ISSN: 0300-9173
• DOI: 10.3143/geriatrics.14.245

Electrocardiographic changes following gastric surgery in the aged were investigated with special reference to the amount of blood transfusion. The subjects were composed of 59 patients with gastric cancer and 19 patients with gastric ulcer, operated on between 1972 and 1975. The postoperative electrocardiographic changes were classified into five groups; that is 1) electrocardiogram simulating myocardial infaction (ESMI) in 8.5%, 2) marked ischemic changes in 10.2%, 3) slight ischemic changes in 8.5%, 4) non-specific ST, T changes in 18.6% and 5) no change in electrocardiogram in 54.2% in the group of gastric cancer. In the group of gastric ulcer these electrocardiographic changes were Observed in 5.3%, 21.0%, 15.8%, 15.8%, and 42.1% respectively, and no difference was found in both groups. The patients received blood transfusion of more than 1000ml in perioperative period were susceptible to the ESMI or ischemic changes, and revealed these changes in 45.5% in the gastric cancer and in 71.4% in the gastric ulcer. The elevation of hematocrit after surgery was correlated with the severity of electrocardiographic changes. In the gastric cancer hematocrit elevated by 15.7 in ESMI, by 10.5 in marked ischemic changes and by 8.4 in slight ischemic changes. In the gastric ulcer the increases in hematocrit were by 9.0, 13.5, and 5.3 respectively. The post operative hematocrit was slightly higher in ESMI, but the hematocrits in the remaining four groups were at the same levels. GOT changes were within normal ranges, and LDH increased slightly in each group. The duration of the operation was similar in each electrocardiographic changes, but the emergency operation was frequently observed in the groups of ESMI and marked ischemic changes. Eighteen cases of gastric cancer and 7 cases of gastric ulcer died during the follow up period. These cases were frequently observed in groups of ESMI and marked ischemic changes. However, no significantly correlation was found between the electrocardiographic changes and coronary stenotic index. The proposed mechanisms responsible for the electrocardiographic changes were rapidly increased hematocrit and blood viscosity in poor risk patients, which might disturb the coronary microcirculation.