Μαρία Νανά, Καθηγήτρια Καρδιολογίας, Ιατρική Σχολή, ΕΚΠΑ
Φωτούλα Μπαμπάτσικου , RN,MD,MPH,PhD, Αναπλ. Καθηγήτρια, Νοσηλευτική, ΤΕΙ ΑΘΗΝΩΝ
Νικόλαος Μπουρμπούλης , Διδάκτωρ Ιατρικής σχολής Αθηνών, Επεμβατικός Καρδιολόγος, Διευθυντής Α’ Καρδιολογικής κλινικής ΚΟΡΓΙΑΛΕΝΕΙΟ-ΜΠΕΝΑΚΕΙΟ
Introduction: The colonoscopy is in general a safe examination, however rarely may be observed various complications related to the alimentary, cardiovascular and respiratory system.
Aim : It was to investigate the frequency of ECG changes, particularly of ischemic myocardial lesions after colonoscopy and to correlate the findings with the patient's history, anthropometric and disease characteristics.
Methodology: The study included 100 consecutive patients who underwent colonoscopy for various indications, aged over 50 years old and regardless of sex and accompanying diseases. Patients were excluded when an anesthesiologist was required. Fentanyl (or alfentanil) was administered as analgesic and midazolam as sedative agent.
Results: Men were 54.4% of the sample, and the mean age of the participants was 67,01 ± 8,89 years. The mean BMI was 26,60 ± 5,07. Polypectomy was performed in 15%. Screening colonoscopy was performed in 19.0%. The ECG remained without any changes in 78% of cases. The changes regard mainly the flattening/becoming negative of the T wave in 12% of cases. In the age group over 68 years, 25% had ECG changes, while the rate was limited to 19.2% in the group below 68 years old. The 15.3% of those who performed colonoscopy screening showed ECG changes, compared with 24.3% of those who did so for other reasons (eg removal of polyps) .The difference in troponin and CPK values before and after the procedure was statistically significant ( p<0,05). During colonoscopy, a marginally statistically significant drop in diastolic blood pressure (p = 0,07): 75,42 ± 14,24 75,81 ± 12,78 compared before and 78,16 ± 11,49 after the procedure.
Conclusions: The results of this study show a considerable percentage ECG changes after colonoscopy, but accompanied by minimal clinical semiotics and should be considered very carefully by the respective biochemical findings. Also, as was shown,
the ECG changes were more common in overweight / obese, those who were older, and those who colonoscopy performed for reasons other than prevention.