Transient ECG Changes in Patients With Acute Biliary Disease
Transient ECG Changes in Patients With Acute Biliary Disease
Background:

 The importance of ischemic ECG changes including St segment elevation, ST segment depression
 or T wave inversion that indicate myocardial ischemia are well established and require
 appropriate investigation and treatment.

 However, there is an abundance of clinical situation, with apparently ischemic ECG change not
 indicate traditionally coronary artery related ischemia and therefore require prompt
 recognition and treatment of underlying condition, that may be serious and life-threatened.
 For example of such conditions are pericarditis, myocarditis, aortic dissection, electrolyte
 abnormalities, intracranial hemorrhage and hypothermia.

 Together with them, an ECG ST segment changes may appeared in abdominal serious illness such
 as pancreatitis and cholecystitis(17,18,19,20,23). Whereas in pancreatitis various vasoactive
 and toxic for myocardium substances released, the cause of ST segment changes in
 cholecystitis are discussed and includes tachycardia , vagal reflexes, changed in plasma
 rennin activity resulted by distension of the gallbladder.

 The certain proportion of the patients with ECG changes actually didn't have coronary artery
 disease(9,15) or other acute cardiac condition and therefore require treatment of the
 underlie illness only without spend the time for cardiac investigation or special
 treatment(1,3,4,7,8). Some kind of treatment may be even harmful for the patients with
 abdominal illness such as thrombolytic, anticoagulant, aggressive antiaggregant therapy or
 unnecessary cardiac catheterization.

 In the medical literature the investigators found some case reports and works about the ECG
 changes in acute biliary disease in patient with knowing cardiac disease and without it, but
 actually incidence of ECG changes that suggest but not represent an acute coronary illness
 isn't knowing.

 Therefore this is necessary to investigate actually incidence of ECG changes that mimic acute
 coronary syndrome in acute cholecystitis and acute biliary disease and determined clinical
 and laboratory characteristics that helps to differentiate this patients.
Inclusion Criteria:

 1. Patients from age 18 and up to 75years old.

 2. Causes of admission to the ED are acute cholecystitis, biliary colic, acute
 cholangitis

 3. The patient is willing to participate in the study and is able to sign an informed
 consent form.

 Exclusion Criteria:

 1. Elective hospitalization with known and not acute condition.

 2. Inability to give inform consent .

 3. Sepsis as complication of illness.

 4. Chronic ECG changes known by medical history.

 5. Knowing history of IHD.

 6. Previous cardiac catheterization with documented stenosis of at least 1 major coronary
 artery equal or more 50%.