As the aged population increases general complications of patients with head and neck cancer have increased. Then previous and present general illnesses of the patient should be carefully noted and decisions on his best therapies should be done.
This paper describes a case of gingival cancer with heart and lung complications, and postoperative transient myocardial ischemia from the aspect of patient management.
The patient was a 72-year-old male with gingival cancer of the mandible (T1N0M0) who suffered from pulmonary fibrosis, secondary pneumonia and a complete left bundle branch block (LBBB). The patient was treated with radical surgery under general anesthesia (GOF) and tolerated the procedure well, and subsequently was sent to the ICU, though he was in satisfactory condition.
He did not complain of dyspnea and chest pain ST segment depression and negative T wave were caused by nasopharyngeal pain of the feeding tube, by coughing, and by changes of body positions in the early postoperative period. Laboratory examinations, such as CK and LDH isoenzymes showed normal valves. On the eleventh day negative T wave returned to normal. These findings suggested transient myocardial ischemia. Ambulatory electrocardiographic and echocardiographic observations revealed no underlying cause of transient myocardial ischemia and LBBB.
Further severe pulmonary complication after surgery had been prevented by urged expectoration, sustained maximum inspiration, subseqent oxygen therapy, control of pain and medicaticn of antibiotics.
