Korean J Gastroenterol.  2010 Oct;56(4):249-254. 10.4166/kjg.2010.56.4.249.

A Case of Acute Myocardial Infarction Occurred Immediately after Endoscopic Submucosal Dissection

• Lee JM
• Lee HW
• Hong YS
• Kim ES
• Park KS
• Cho KB
• Hwang JS
• Kim H

• KMID: 1718361
• DOI: http://doi.org/10.4166/kjg.2010.56.4.249

Abstract

Endoscopic methods such as endoscopic mucosal resection or endoscopic submucosal dissection (ESD) have been increasingly used for the treatment of gastric adenoma and early gastric cancer. Especially, ESD is very useful since it allows en bloc resection of large lesions. Bleeding and perforation are well known as common complications after ESD. However, there is no report of acute myocardial infarction associated with ESD. We report a case of acute myocardial infarction which was detected immediately after ESD.

Keyword

Endoscopic submucosal dissection; Complications; Acute myocardial infarction

MeSH Terms

Acute Disease
Adenoma/surgery
Aged
Coronary Angiography
Dissection/*adverse effects
Endoscopy, Gastrointestinal
Female
Gastric Mucosa/surgery
Humans
Myocardial Infarction/*diagnosis/etiology/radiography
Stomach Neoplasms/surgery

Figure

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  Fig. 1. Endoscopic findings. (A) About 3×3 cm sized elevated lesion with central depression and vague margin was noted in the posterior side of gastric angle. (B) Iatrogenic ulcer after dissection was noted.

• 

  Fig. 2. Chest AP views. (A) Patchy consolidation was noted in the diffuse left lung field after procedure. (B) On the 2 nd admission day, the improvement of patchy consolidation was noted.

• 

  Fig. 3. ECG findings. (A) Abnormal Q waves and elevated ST segments were noted in aV L lead, and ST segments depressions in II, III, aV F, and V4-6 leads. (B) On the 4 th admission day, in spite of persistent abnormal Q waves in aV L lead, normalized ST segments were observed in all leads.

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  Fig. 4. Coronary angiography. It showed 75% stenosis in prox-imal obtuse marginal branch of left circumflex artery.

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  Fig. 5. Overall course of the patient in the hospital. The patient were discharged on the 10 th admission day.

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