Journal of Research in Applied and Basic Medical Sciences

en De novo ECG changes in patients without a history of heart problems presenting with acute cholecystitis: etiology and clinical importance Internal Medicine Specialist پژوهشي orginal article Background & Aims: Acute cholecystitis, primarily an inflammatory condition of the gallbladder, has been associated with electrocardiographic (ECG) changes that mimic cardiac pathology. While laparoscopic cholecystectomy is a well-established treatment for acute cholecystitis, its potential impact on postoperative ECG changes in patients without pre-existing cardiovascular disease remains unclear. This study aims to investigate the incidence and nature of ECG alterations following laparoscopic cholecystectomy in patients without prior cardiac disease. Materials & Methods: In this single-arm cohort study, we reviewed 75 patients who underwent laparoscopic cholecystectomy for acute cholecystitis at Firouzabadi General Hospital between March 2020 and March 2021. Patients with pre-existing cardiac conditions or abnormal preoperative ECGs were excluded. A 12-lead ECG was performed within 48 hours before and 24 hours after surgery. ECGs were analyzed by a cardiologist and an internist, and discrepancies were resolved through consensus. The difference in the incidence of postoperative ECG changes was assessed using McNemar’s Chi-Square test. Results: Among the 75 patients included (mean age: 47.38 ± 13.16 years, 74.7% female), four patients (5.3%) had benign T-wave inversions before surgery. Following surgery, 13 patients (17.3%) exhibited new ECG changes, including T-wave inversions (precordial: 5, limb leads: 5) and ST-segment depressions (precordial: 1, limb leads: 2). McNemar’s Chi-Square test indicated a statistically significant increase in ECG changes postoperatively (p = 0.012). All patients were discharged without persistent ECG abnormalities or major postoperative complications. Conclusion: This study suggests a potential association between laparoscopic cholecystectomy and transient ECG alterations in patients without prior cardiac disease. Proposed mechanisms include gallbladder manipulation, sympathetic adrenergic stimulation, and laparoscopy-induced hemodynamic stress. Future studies with larger cohorts and control groups undergoing non-biliary laparoscopic surgeries are needed to delineate the effects of cholecystectomy from those of laparoscopy itself on cardiac electrophysiology. Acute cholecystitis, Electrocardiographic changes, Laparoscopic cholecystectomy, Postoperative cardiac monitoring, Sympathetic stimulation 186 192 http://ijrabms.umsu.ac.ir/browse.php?a_code=A-10-134-11&slc_lang=en&sid=1 Shahin Keshtkar Rajabi keshtkat.sh@iums.ac.ir 10031947532846004194 10031947532846004194 No Firoozabadi Clinical Research Development Unit, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Shadab Dalirani dalirani.sh@iums.ac.ir 10031947532846004195 0009-0009-8129-8681 No School of Medicine, Iran University of Medical Sciences, Tehran, Iran Nima Azh nimaazh75@gmail.com 10031947532846004196 10031947532846004196 No School of Medicine, Iran University of Medical Sciences, Tehran, Iran Nogol Motamedgorji nogolgorji@gmail.com 10031947532846004197 10031947532846004197 No School of Medicine, Iran University of Medical Sciences, Tehran, Iran Mohammad Amin Abbasi amin.abbasi1314@gmail.com 10031947532846004198 0009-0004-8315-9507 Yes Firoozabadi Clinical Research Development Unit, School of Medicine, Iran University of Medical Sciences, Tehran, Iran