Acute electrocardiographic changes after pneumonectomy

Background. Postpneumonectomy electrocardiographic (ECG) changes have not b een well-defined. Methods, We reviewed the clinical data and the preoperative and postpneumon ectomy ECGs of 15 patients who had pneumonectomy. Results, All postpneumonectomy ECGs showed a higher heart rate and two (13% ) showed diffuse ST elevation. Four patients (27%) had transient atrial arr hythmias. Five patients (33%) had some ECG findings of acute cor pulmonale. A leftward shift of the QRS axis occurred after left pneumonectomy, The pr ecordial transitional zone shifted counterclockwise after right pneumonecto my. Conclusions. Except for one case of septal myocardial infarction, postpneum onectomy ECG changes appeared to result from the pneumonectomy and not from cardiopulmonary disease. Recognition of expected postpneumonectomy ECG fin dings will help avoid confusing these changes with acute cardiac and pulmon ary events, which should reduce patient morbidity and costs.