Certain conditions are associated with an increased risk for an adverse perioperative cardiovascular event.
Perioperative cardiovascular events include:
(1) myocardial infarction
(2) congestive heart failure
(3) sudden death
Predictor of Perioperative Cardiovascular Event
unstable coronary syndrome
decompensated congestive heart failure
severe valvular disease
mild angina pectoris (Canadian Class I or II)
prior myocardial infarction by history or pathological Q waves
compensated or prior congestive heart failure
rhythm other than sinus (atrial fibrillation, etc.)
low exercise tolerance
history of stroke
uncontrolled systemic hypertension
• Unstable coronary syndromes include recent myocardial infarction with evidence of important ischemic risk from clinical symptoms or noninvasive study, and unstable or severe angina (Canadian Class III or IV).
• Serious arrhythmias include high grade atrioventricular block, symptomatic ventricular arrhythmias in the presence of underlying heart disease, supraventricular arrhythmias with uncontrolled ventricular rate.
• Abnormal electrocardiogram includes ventricular hypertrophy, bundle branch block, or ST-T wave abnormalities.
• Uncontrolled systemic hypertension may be associated with marked changes in blood pressure during and after surgery, with associated myocardial ischemia.
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Specialty: Cardiology, Surgery, general, Surgery, orthopedic