RESUMO
BACKGROUND: Cardiorespiratory complications may occur during gastrointestinal endoscopy, and elderly people seem to be more vulnerable to these complications during endoscopic procedures involving the manipulation of abdominal viscera. OBJECTIVES: To determine the incidence of cardiac arrhythmias, changes in oxygen saturation, heart rate and blood pressure during endoscopic retrograde cholangiopancreatography (ERCP) via Holter monitoring in elderly patients older than 70 years of age. METHODS: Holter monitoring and 12-lead electrocardiograms were performed in 30 elderly patients undergoing ERCP and in 30 control subjects undergoing routine chest, abdomen, bone and upper gastrointestinal small bowel follow-through studies. A computerized nontriggered template system was used to analyze the electrocardiograms qualitatively and quantitatively. Arrhythmias, cardiac axis, conduction defects, pauses, ST segment changes, ectopic beats, oxygen desaturation and changes in blood pressure and rate-pressure product were evaluated. RESULTS: Increased heart rate, ST segment changes resulting from myocardial ischemia, oxygen desaturation and transient atrial and ventricular ectopic beats were frequent during ERCP compared with the control group. In one patient, transient left bundle branch block developed and this was attributed to pre-existing hypertension with cardiomegaly. One patient developed ventricular tachycardia and one other sinus bradycardia, but this was attributed to sick sinus syndrome. CONCLUSIONS: Transient myocardial ischemia and various cardiac arrhythmias are frequent in elderly patients undergoing ERCP. Appropriate noninvasive monitoring seems to be justified during this procedure.
Assuntos
Colangiopancreatografia Retrógrada Endoscópica , Eletrocardiografia , Idoso , Arritmias Cardíacas/epidemiologia , Arritmias Cardíacas/etiologia , Pressão Sanguínea , Estudos de Casos e Controles , Eletrocardiografia Ambulatorial , Feminino , Frequência Cardíaca , Humanos , Incidência , Masculino , Isquemia Miocárdica/epidemiologia , Isquemia Miocárdica/etiologia , Oxigênio/sangueRESUMO
A case in which inspissated barium was retained and produced sigmoid obstruction after one year is described. The patient was elderly and myxoedematous. Prolonged retention of barium producing a bowel obstruction requiring surgery is a rare complication and, to our knowledge, is only the second case described in which the symptoms of obstruction appeared so late after the examination.
Assuntos
Sulfato de Bário/efeitos adversos , Doenças do Colo/induzido quimicamente , Meios de Contraste/efeitos adversos , Obstrução Intestinal/induzido quimicamente , Idoso , Doenças do Colo/cirurgia , Feminino , Humanos , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/cirurgia , Radiografia , Resultado do TratamentoRESUMO
Electrocardiographic, roentgenographic and clinical findings from 5 patients with intrathoracic conditions were studied. Three patients suffering from left spontaneous pneumothorax and one from eventration of the left diaphragm were found to have an unusual phasic voltage alternation in their electrocardiograms. These changes were appearing during the course of the disease and disappearing with the correction of the condition. Respiratory variation of intrathoracic anatomy or amplitude and swinging of the heart seems a possible explanation.