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Detection and management of perioperative myocardial ischemia

Biccard, Bruce M.

Current Opinion in Anaesthesiology:
doi: 10.1097/ACO.0000000000000071
ANESTHESIA AND MEDICAL DISEASE: Edited by Natalie Holt
Editor's Choice
Abstract

Purpose of review: To review the current evidence for detection and management of perioperative myocardial ischemia.

Recent findings: Patients who sustain a myocardial injury after noncardiac surgery are predominantly asymptomatic. Myocardial injury after noncardiac surgery is associated with both short-term and long-term mortality. Mortality from both cardiac and noncardiac causes is significant.

Summary: Perioperative physicians should refrain from the use of nonsurgical diagnostic criteria for myocardial infarction and adopt the clinical entity known as myocardial injury after noncardiac surgery in order to allow for better determination of the prevalence of this perioperative complication. Studies should focus on establishing the feasibility of broad postoperative troponin surveillance following noncardiac surgery. Clinical trials of potential therapies for myocardial injury after noncardiac surgery are urgently needed.

Author Information

Perioperative Research Group, Department of Anaesthetics, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa

Correspondence to Bruce M. Biccard, Department of Anaesthetics, Nelson R Mandela School of, Medicine, University of KwaZulu-Natal, Private Bag 7, Congella, 4013, KwaZulu-Natal, South Africa. Tel: +27 31 260 4328; fax: +27 31 260 4433; e-mail: biccardb@ukzn.ac.za

© 2014 Lippincott Williams & Wilkins, Inc.