[The heart as the field of conflict between surgery and anesthesia]

Both surgical trauma and anesthesia have an important impact on the heart and its function. The operation affects the heart by sympathoadrenergic stress reaction, blood loss, and various surgical manipulations all of which challenge its functional reserve. Although anesthesia should protect the heart against the untoward effects of the operation, it may itself compromise cardiovascular function. The understanding of the complex interactions between surgery and anesthesia is essential for the perioperative management of the cardiovascular system. Taking these interactions into account ensures a safe, complication-free anesthesia even in patients with heart disease.