Figure 1: ECG recordings. A: preoperative, B-D during the event over a ten minutes period. ECGs showed sinus tachycardia and diffuse STsegment depression in combination with progressive axis deviation towards the right. In addition to the development of an S wave in lead 1 and a Q wave in lead III with an incomplete right bundle branch block (RBTB) developed, suggestive of acute right ventricular strain.