The Postoperative Electrocardiogram

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Abstract
A study of 3580 consecutively operated patients (none had cardiac surgery) revealed that 85, or 2.4%, presented with abnormal postoperative electrocardiograms. The latter were of many types, most of them of a serious nature. The majority of these patients with asymptomatic. Eleven of these individuals died; autopsies were obtained in four. The anesthesia used for all patients was cyclopropane or Fluothane general anesthesia. The duration of the surgery was up to 4 hr. Most of the operations performed were for pathology of the abdominal viscera, especially gallbladder. The electrocardiographic changes consisted of various types of arrhythmias, conduction disturbances, and patterns of myocardial ischemia and infarction. The source of the electrocardiographic aberrations could not be easily traced, but the best correlation concerned those with prolonged periods of hypotension during surgery. Yet other factors such as electrolytes, blood volume, length of surgery and underlying coronary sclerosis must play an important role. Routine preoperative serial electrocardiograms are suggested.