[The perioperative myocardial infarction - an interdisciplinary task]

Area of Science:

• Cardiology
• Anesthesiology
• Cardiac Surgery

Background:

• Cardiovascular complications, especially perioperative myocardial infarction (PMI), significantly increase mortality after noncardiac surgery.
• PMI often presents asymptomatically, lacking typical symptoms or ECG changes, complicating early diagnosis.
• The silent nature of PMI, coupled with its high associated mortality, necessitates heightened clinical vigilance.

Purpose of the Study:

• To underscore the importance of recognizing perioperative myocardial infarction (PMI) in noncardiac surgery.
• To highlight the diagnostic challenges and high mortality associated with asymptomatic PMI.
• To emphasize the need for prompt diagnosis and management of PMI.

Main Methods:

• Utilizing cardiac troponin measurements as a key diagnostic tool.
• Employing 12-lead electrocardiogram (ECG) for diagnostic confirmation.
• Reviewing the clinical presentation and timing of perioperative myocardial infarction.

Main Results:

• Perioperative myocardial infarction (PMI) is a significant cause of death post-noncardiac surgery.
• Most PMIs occur within the first three days following surgery.
• PMI can be categorized into Type I (plaque rupture) and Type II (supply-demand imbalance).

Conclusions:

• Increased awareness of perioperative myocardial infarction (PMI) is critical due to its high mortality and diagnostic difficulties.
• Early detection and management of PMI, particularly within the first 72 hours post-surgery, are essential.
• Effective PMI therapy requires multidisciplinary collaboration among surgeons, anesthesiologists, and cardiologists.