Electrocardiographic Changes after Bilateral Carotid Endarterectomy

WE have observed striking electrocardiographic changes that simulated subendocardial infarction in patients without clinical evidence of infarction who had undergone bilateral carotid endarterectomy. Patients, Methods and Results Five consecutive patients (Table 1) with transient ischemic attacks were examined with standard 12-lead electrocardiograms (Marquette electrocardiograph) before and after staged (five to 25 days apart), bilateral, standard-bifurcation carotid endarterectomies without use of an internal shunt. No patient experienced hypotension during or after the operation or was on a drug known to influence the electrocardiogram. Serial measurements of glutamic oxalacetic tramsaminase and isoenzymes of lactic dehydrogenase were within normal limits before and after.