title: Endoscopic retrograde cholangiopancreatography causes reduced myocardial blood flow.
abstract: OBJECTIVE
  Previous studies have shown that up to 50% of healthy patients may develop ST-segment changes during upper gastrointestinal endoscopy. The aim of the study was to evaluate myocardial blood flow in patients during endoscopic retrograde cholangiopancreatography (ERCP).
  
  
  METHODS
  11 patients scheduled for ERCP were monitored with a Holter tape recorder and underwent myocardial perfusion scintigraphies, to evaluate myocardial perfusion at rest and during ERCP.
  
  
  RESULTS
  Ten patients completed the study. Eight patients had no sign of myocardial ischemia with either of the two methods, while two patients developed signs of ischemia during ERCP with both the Holter tape recording and on myocardial scintigraphy (P = 0.02).
  
  
  CONCLUSIONS
  Patients undergoing ERCP may develop true myocardial ischemia with reduced myocardial blood flow. Although this is a small-scale study, these findings strongly support the use of alternative methods for diagnostic evaluation of the pancreatic duct and biliary tree.
authors.affiliation: Department of Surgical Gastroenterology, Hvidovre University Hospital, Hvidovre, Denmark. merete.Christensen@dadlnet.dk
authors.forename: M
authors.initials: M
authors.lastname: Christensen
authors.forename: H W
authors.initials: HW
authors.lastname: Hendel
authors.forename: V
authors.initials: V
authors.lastname: Rasmussen
authors.forename: L
authors.initials: L
authors.lastname: Højgaard
authors.forename: S
authors.initials: S
authors.lastname: Schulze
authors.forename: J
authors.initials: J
authors.lastname: Rosenberg
mesh_terms: D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D003326:Coronary Circulation; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*; D010183:Pancreatic Ducts / Q000473:pathology*; D011877:Radionuclide Imaging