Serum Enzyme and Electrocardiographic Changes after Coronary Artery Surgery

Correlation with Selective Cine Coronary Arteriography and Left Ventriculography

¹ Department of Cardiovascular Disease and Cardiac Laboratory, and the Department of Clinical Cardiology, The Cleveland Clinic Foundation, Cleveland, Ohio

The preoperative and postoperative serum enzyme determinations and electrocardiograms of 125 patients who underwent cardiac surgery were reviewed. Eighty-one patients underwent single or double internal mammary artery implantation. A patch-graft or vein-graft procedure for severe segmental obstructions was performed in 30 patients. A ventricular aneurysmectomy was performed in five patients, whereas nine underwent prosthetic valve replacement. Correlation with the electrocardiogram and serum enzyme activity was made with cine coronary arteriography and left ventriculography in 100 of 125 patients. The levels of SGOT, LDH, and CPK were found to be elevated after a variety of surgical procedures for coronary artery disease, but notable increases in the levels were attributed to acute myocardial infarction or external cardiac massage with DC defibrillation in the majority of patients. For the most part there was good correlation between enzyme responses and electrocardiographic changes. Usually, left ventriculography confirmed the diagnostic accuracy of serial electrocardiograms and enzyme determinations in the clinical recognition of acute transmural myocardial infarction.