ACUTE CARDIOVASCULAR COMPLICATIONS OF ENDOSCOPY - PREVALENCE AND CLINICAL CHARACTERISTICS

We sought to determine the prevalence of acute cardiovascular complications of endoscopy and to describe the clinical features associated with such events. Acute cardiovascular complications were identified from a computerized database of all endoscopies performed at our institution, and their clinical histories were abstracted from the medical records. Of 21,946 endoscopic procedures performed between August 1, 1988, and December 31, 1992, 9 women and 22 men (0.14%) developed acute cardiovascular complications including vasovagal reaction (24), supraventricular tachycardia (4), myocardial infarction (2) and congestive heart failure (1). Fourteen patients had underlying coronary artery disease and 4 others exertional angina; 20 of 25 electrocardiograms available before the endoscopy were abnormal. Twenty patients required treatment during, endoscopy, but only 3 needed continued therapy. One patient died of a periprocedural acute myocardial infarction, Seven (23%) patients experienced additional cardiac events during the follow-up period of 21.8 +/- 15.8 months, In conclusion, acute cardiovascular complications of endoscopy are infrequent and usually self-limited; serious complications occurred exclusively in the setting of known underlying heart disease.