Mechanical compression or post-operative focal inflammation of the anterior right ventricle following retro-sternal stomach placement may induce transient Brugada-like ECG changes.
Transient Brugada-like ECG changes may follow retro-sternal stomach placement; leaves open whether RV compression or inflammation is causative.
A 63-year-old male was admitted to our surgical department for an operation for oesophageal cancer. He had no episodes of syncope or a family history of sudden death. On admission, 12-lead electrocardiogram (ECG) showed atrial fibrillation but no ST-segment elevation. He underwent resection of the oesophagus followed by retro-sternum placement of the stomach (upper panel). After the operation, his ECG showed marked ST elevation in leads V1–V3 which increased on the second day post-operation and was followed gradual normalization of the ECG thereafter (lower panel). High-grade fever was not observed and no relevant drugs increasing ST elevation were used. Mechanical compression and/or post-operative focal inflammation of the anterior right ventricle may be the mechanism of this phenomenon. Conflict of interest: none declared.
No takes yet. Share an insight, caveat, or question.
Sasaki et al. (2010) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: