Key result
Anesthesia induction linked to sudden non-ischemic global T-wave inversion persisting for 2 months.
Why the study?
Detection and management of suspected intraoperative myocardial ischemia are critical for patient outcome, but interpreting isolated perioperative ECG changes requires caution.
Case Report (n=1)
Isolated perioperative ECG changes such as T-wave inversion should be interpreted with caution when troponin is negative to avoid unnecessary and potentially invasive investigations.
Answers are grounded in this paper and cite their sources.
Requires cautious interpretation of isolated perioperative T-wave inversion with negative troponin; leaves open non-ischemic etiologies for persistent ECG changes.
Detection and management of suspected intraoperative myocardial ischemia are critical for patient outcome. Following induction of general anesthesia, sudden global T-wave inversion appeared on continuous electrocardiogram (ECG) monitoring, raising suspicion for acute myocardial ischemia and prompting cancellation of surgery. The patient underwent a thorough evaluation for myocardial ischemia despite negative circulating troponin, but all tests were negative. The T-wave inversion persisted for 2 months. This case highlights the need for caution in interpreting isolated perioperative ECG changes in the era of heightened awareness for perioperative myocardial ischemia and routine troponin screening, to avoid unnecessary and potentially invasive investigations.
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Puppo et al. (2026) conducted a case report in Suspected intraoperative myocardial ischemia (n=1). General anesthesia induction was evaluated. Sudden global T-wave inversion during anesthesia induction prompted extensive but negative evaluation for myocardial ischemia, with ECG changes persisting for 2 months.
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