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
|
Significance |
Predictor of Perioperative Cardiovascular Event |
|
major predictors |
unstable coronary syndrome |
|
|
decompensated congestive heart failure |
|
|
serious arrhythmias |
|
|
severe valvular disease |
|
intermediate predictors |
mild angina pectoris (Canadian Class I or II) |
|
|
prior myocardial infarction by history or pathological Q waves |
|
|
compensated or prior congestive heart failure |
|
|
diabetes mellitus |
|
minor predictors |
advanced age |
|
|
abnormal electrocardiogram |
|
|
rhythm other than sinus (atrial fibrillation, etc.) |
|
|
low exercise tolerance |
|
|
history of stroke |
|
|
uncontrolled systemic hypertension |
where:
• 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.
Specialty: Cardiology, Surgery, general, Surgery, orthopedic
ICD-10: ,
