We present an EKG monitoring strategy to detect pneumothorax during high-risk surgery. In the literature, EKG changes and pneumothorax are well-described. However, anesthesiologists only monitor lead II on a three-lead EKG system in the operating room. In our case, there was only a subtle change in lead II for a left-sided pneumothorax, which could have been easily missed. On the contrary, there was a marked QRS amplitude reduction and T wave flattening/inversion in lead I and V5 . We recommend lead V5 be added to the continuous monitoring and lead I be periodically checked for surgeries known to potentially cause pneumothorax.
Keywords: electrocardiographic changes; intraoperative monitoring; nephrectomy; pneumothorax.
© 2022 The Authors. Annals of Noninvasive Electrocardiology published by Wiley Periodicals LLC.