Intrapericardial pneumonectomy (the removal of a part or all of a lung) is associated with acute coronary syndrome and myocardial infarction.
There are different clinical reasons for why some patients undergo to lung surgeries. The main purpose is to repair or remove lung tissue, usually following cancer, collapsed lung tissue, tumors or other conditions. The procedure may cause not only result in complications related to the lung tissues, but also heart rhythm disturbances. For example, the repositioning of structures and organs in the chest after lung surgery may cause electrocardiographic (ECG) changes. A rapid and irregular heart rate rhythm (atrial fibrillation) and ECG changes suggestive of ischemia (pseudoischemic ECG changes) seem to be the most prevalent abnormalities in patients after lung surgeries.
Serbian researchers published a case report of ECG abnormalities in a 68-year-old male who underwent lung surgery, pneumonectomy, without any prior cardiovascular diseases. The patient underwent an intrapericardial right pneumonectomy for lung cancer, and had ECG signs of pseudoischemia and clinical symptoms and signs that correspond to acute myocardial infarction on the second postoperative day. Authors suggested that the type and magnitude of the lung resection were responsible for physical lesions in the pericardium that caused an acute coronary syndrome.
ECG abnormalities are strongly correlated with postoperative changes in the anatomy of the chest cavity. A close clinical assessment and follow-up after intrapericardial pneumonectomy is a key strategy for the early diagnosis of acute coronary syndrome and myocardial infarction.
Written By: Vagner Raso