The Recognition of Myocardial Infarction in the Early Postoperative Period

ALTHOUGH the prompt detection of myocardial infarction may be vital to a patient who has just undergone an operation, the diagnostic signs may have been so obscured by medications and other factors that recognition is difficult. The electrocardiographic changes noted in many cases are often of little clinical significance. Similarly, the usefulness of serum enzyme determinations in the postoperative period has remained uncertain. Of the many enzyme patterns studied by research chemists, few have emerged as useful clinical tools, and alterations induced by surgical procedures have not been clearly defined or correlated with other diagnostic studies. The study reported here was undertaken to determine whether the correlation of serial ECG patterns with enzyme levels, hematocrit values, and leukocyte counts might help to establish diagnostic criteria for myocardial infarction following various operations. On the basis of such correlations in a series of 84 cases, it appears that myocardial infarction may be