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[Cardiac risk patients in anesthesia].

E R Schmid1

  • 1Institut für Anästhesiologie, Universitätsspital Zürich.

Therapeutische Umschau. Revue Therapeutique
|June 1, 1991
PubMed
Summary

Patients with heart conditions can undergo non-cardiac surgery safely. Careful anesthetic management and monitoring minimize cardiac risks during and after these operations.

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Area of Science:

  • Anesthesiology
  • Cardiology
  • Perioperative Medicine

Context:

  • Cardiac complications are a leading cause of death in patients undergoing non-cardiac surgery.
  • High-risk patients include those with coronary artery disease, heart failure, or aortic stenosis.
  • Certain surgical factors like prolonged duration, hypotension, and tachycardia increase cardiac risk.

Purpose:

  • To review the risks and anesthetic management of non-cardiac surgery in patients with cardiac disease.
  • To highlight strategies for minimizing perioperative cardiac events.
  • To emphasize the importance of hemodynamic monitoring and potential need for cardiac surgery prior to non-cardiac procedures.

Summary:

  • Non-cardiac operations can be performed safely in high-risk cardiac patients, even those awaiting heart transplantation.
  • Successful management hinges on understanding the patient's cardiac condition, hemodynamic principles, anesthetic drug effects, and advanced monitoring.
  • Preoperative cardiac surgery may be indicated for severe coronary or valve disease.
  • Postoperative monitoring in an intensive care unit is crucial due to the high incidence of complications.

Impact:

  • Enables informed decisions regarding surgical risk assessment for patients with cardiac conditions.
  • Guides anesthetic strategies to improve outcomes in complex surgical cases.
  • Underscores the importance of multidisciplinary care involving cardiology, surgery, and anesthesiology.
  • Supports the principle that indicated surgery should not be withheld solely based on cardiac risk.

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