• A&A practice · Feb 2020

    Case Reports

    New Q Waves and T-Wave Inversions Following Endovascular Surgery Lead to Diagnosis of Clinically Silent Myocardial Infarction Despite Negative Preoperative Cardiovascular Risk Evaluation: A Case Report.

    • Daniel J Delaney, Paul A Warner, and Matthew J Ritter.
    • From the Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota.
    • A A Pract. 2020 Feb 15; 14 (4): 112-115.

    AbstractIn this case, a 79-year-old male presented with new anteroseptal Q waves and T-wave inversions across the precordial leads following an otherwise uneventful endovascular repair of his thoracoabdominal aortic aneurysm. The patient had no history of cardiac disease and had undergone a dobutamine stress echocardiogram within the preceding 6 months that showed no evidence of inducible ischemia. Nevertheless, routine postoperative electrocardiogram (EKG) revealed new Q waves and T-wave inversions and transthoracic echocardiogram that demonstrated akinesis of the left ventricle (LV) apex with chronic-appearing apical thrombus. We will further discuss preoperative evaluation of cardiovascular risk along with postoperative interpretation of EKG abnormalities.

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