Stunned myocardium after hip arthroplasty.
We report a case of ST-segment elevation occurring in all leads of the ECG during hip arthroplasty. It is thought that this resulted from a stunned myocardium because wall motion abnormalities were reversible, there was no evidence of fixed or vasospastic coronary occlusion and there was only a slight increase in serial cardiac enzymes. Treatment with nicorandil improved the patient's cardiac function. A [123I]MIBG test revealed a high myocardial washout rate, suggesting that the stunned myocardium was caused by exposure to excessive norepinephrine induced by anaesthesia or surgery.
Mizogami
M
M
Department of Anaesthesiology, Asahi University, Gifu-ken, Japan.
Shimo
K
K
Taguchi
T
T
Horita
Y
Y
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D017682:Myocardial Stunning / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D020108:Nicorandil / Q000627:therapeutic use*; D015899:Tomography, Emission-Computed, Single-Photon; D014700:Verapamil / Q000627:therapeutic use*
D000889:Anti-Arrhythmia Agents; D020108:Nicorandil; D014700:Verapamil