title: Acute "Pseudoischemic" ECG Abnormalities after Right Pneumonectomy.
abstract: New onset of electrocardiographic (ECG) abnormalities can occur after lung surgery due to the changes in the position of structures and organs in the chest cavity. The most common heart rhythm disorder is atrial fibrillation. So-called "pseudoischemic" ECG changes that mimic classic ECG signs of acute myocardial ischemia are also often noticed. We report the case of a 68-year-old male, with no prior cardiovascular disease, who underwent extensive surgical resection for lung cancer. On a second postoperative day, clinical and electrocardiographic signs of acute myocardial ischemia occurred. According to clinical course, diagnostic procedures, and therapeutic response, we excluded acute coronary syndrome. We concluded that physical lesion of the pericardium, caused by extended pneumonectomy with resection of the pericardium, provoked the symptoms and ECG signs that mimic acute coronary syndrome. Our final diagnosis was postpericardiotomy syndrome after extended pneumonectomy and further treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) was recommended. It is necessary to consider possibility that nature of ECG changes after extended pneumonectomy could be "pseudoischemic."
authors.affiliation: Clinic for Pulmonary Diseases, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Nada
authors.identifier: 0000-0002-1364-7255
authors.initials: N
authors.lastname: Vasic
authors.affiliation: Clinic for Pulmonary Diseases, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Sanja
authors.initials: S
authors.lastname: Dimic-Janjic
authors.affiliation: Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Center for Radiology and Magnetic Resonance Imaging, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Ruza
authors.initials: R
authors.lastname: Stevic
authors.affiliation: Clinic for Pulmonary Diseases, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Branislava
authors.initials: B
authors.lastname: Milenkovic
authors.affiliation: Clinic for Pulmonary Diseases, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Verica
authors.initials: V
authors.lastname: Djukanovic