title: Stunned myocardium after hip arthroplasty.
abstract: 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.
authors.affiliation: Department of Anaesthesiology, Asahi University, Gifu-ken, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Mizogami
authors.forename: K
authors.initials: K
authors.lastname: Shimo
authors.forename: T
authors.initials: T
authors.lastname: Taguchi
authors.forename: Y
authors.initials: Y
authors.lastname: Horita
mesh_terms: 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*
chemical_list: D000889:Anti-Arrhythmia Agents; D020108:Nicorandil; D014700:Verapamil