{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:27:32Z","timestamp":1753878452801,"version":"3.41.2"},"reference-count":12,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T00:00:00Z","timestamp":1700438400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Noninvasive Electrocardiol"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Abnormal postoperative electrocardiograms are not uncommon, oftentimes leading to further cardiac workup especially when the findings are new and not easily explainable. A forty\u2010year\u2010old woman, with a history of left breast cancer status post bilateral mastectomies and reconstructions, presented for robot\u2010assisted low\u2010anterior resection secondary to rectal cancer. Postoperative electrocardiogram showed poor R wave progression, biphasic T waves in V2\u20104, and possible anterior wall ischemia. Her electrocardiogram from 6\u2009years ago was normal. No recent electrocardiogram was available for comparison. Initially, the abnormal postoperative electrocardiogram appeared worrisome. However, the patient was completely asymptomatic, and all vital signs were normal. Cardiac point\u2010of\u2010care ultrasound showed normal parasternal long and short axis views. The biphasic T waves in V2\u20104 were suggestive of Wellens syndrome, but the accompanying poor R wave progression was not consistent with the diagnostic criteria. The anesthesiologist then remembered the patient's history of the presence of a left breast implant and suspected it might have caused the changes on the electrocardiogram. A literature search did find one publication that shows approximately 45% of patients with breast implants present with electrocardiogram changes, including poor R wave progression and negative T waves. Therefore, no further cardiac workup was ordered for our patient. She was discharged home 3\u2009days later. Breast implants and electrocardiogram changes are a lesser\u2010known topic. Obtaining a pre\u2010operative electrocardiogram should be considered in patients with previous breast implants, to serve as a baseline for comparison if the patient were to need another electrocardiogram in the future.<\/jats:p>","DOI":"10.1111\/anec.13092","type":"journal-article","created":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T18:14:14Z","timestamp":1700590454000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Postoperative electrocardiography changes: To worry or not to worry"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3760-2753","authenticated-orcid":false,"given":"Chihjen","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Cedars\u2010Sinai Medical Center  Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janet","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Cedars\u2010Sinai Medical Center  Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arash","family":"Bereliani","sequence":"additional","affiliation":[{"name":"Department of Cardiology Cedars\u2010Sinai Medical Center  Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liza","family":"Capiendo","sequence":"additional","affiliation":[{"name":"Department of Surgery Cedars\u2010Sinai Medical Center  Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eiman","family":"Firoozmand","sequence":"additional","affiliation":[{"name":"Department of Surgery Cedars\u2010Sinai Medical Center  Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roya","family":"Yumul","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Cedars\u2010Sinai Medical Center  Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,11,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3109\/07853890903555334"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.23174"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.02.5841"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/anec.12718"},{"key":"e_1_2_8_6_1","doi-asserted-by":"crossref","unstructured":"Fleisher L. Fleischmann K. Auerbach A. et al. (2014).2014 ACC\/AHA guideline on perioperative cardiovascular evaluation and Management of Patients Undergoing Noncardiac Surgery vol. 130 issue 24.","DOI":"10.1161\/CIR.0000000000000104"},{"volume-title":"StatPearls","year":"2023","author":"Heaton J.","key":"e_1_2_8_7_1"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549\u2010019\u201005303\u2010y"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/6678503"},{"issue":"7","key":"e_1_2_8_10_1","article-title":"Precordial ECG Lead Mispositioning: Its incidence and estimated cost to healthcare","volume":"12","author":"Rehman M.","year":"2020","journal-title":"Cureus"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/ajem.2002.34800"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11864\u2010020\u20100719\u20101"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/8507096"}],"container-title":["Annals of Noninvasive Electrocardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anec.13092","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T08:42:46Z","timestamp":1706604166000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/anec.13092"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,20]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1111\/anec.13092"],"URL":"https:\/\/doi.org\/10.1111\/anec.13092","archive":["Portico"],"relation":{},"ISSN":["1082-720X","1542-474X"],"issn-type":[{"type":"print","value":"1082-720X"},{"type":"electronic","value":"1542-474X"}],"subject":[],"published":{"date-parts":[[2023,11,20]]},"assertion":[{"value":"2023-04-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13092"}}