Clinically Unrecognized Myocardial Infarction Following Surgery

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Abstract
MYOCARDIAL infarction may occur during surgery or in the postoperative period. The usual clinical picture in the postoperative period may be obscured by incisional pain, respiratory or gastrointestinal complications or by sedation. The associated objective findings of fever, elevated white-cell count and increased sedimentation rate are not diagnostically helpful, and the more recent measurements of serum enzymes — namely, serum glutamic oxalacetic transaminase and lactic dehydrogenase—are of uncertain value after surgical trauma.1 2 3 4 5 6 7 8 9 Hence, shortly after operation the electrocardiogram may provide the only evidence of acute myocardial infarction.Among the reports of postoperative myocardial infarction are those of Master et al., . . .