The patient with ischaemic heart disease undergoing non cardiac surgery

Area of Science:

• Cardiology
• Anesthesiology
• Peri-operative Medicine

Background:

• Ischemic heart disease (IHD) incidence is rising globally.
• Surgical patients with IHD, with or without prior interventions, are increasingly common.
• These patients exhibit elevated risks for peri-operative myocardial ischemia, infarction, and mortality.

Purpose of the Study:

• To review current practices and guidelines for managing patients with IHD undergoing non-cardiac surgery.
• To highlight the increased peri-operative risks in patients with IHD, particularly those with recent myocardial infarction (MI).
• To emphasize the anesthesiologist's role in patient evaluation and peri-operative management.

Main Methods:

• Literature search conducted on PubMed.
• Keywords used included "ischemic heart disease", "anesthesia", "perioperative", and "anesthetic implications".

Main Results:

• Patients with IHD undergoing non-cardiac surgery face increased risks of peri-operative myocardial ischemia, MI, conduction disturbances, morbidity, and mortality.
• The risk is significantly higher in patients with a recent history of MI.
• Anesthesiologists require thorough patient evaluation and awareness of IHD pathophysiology for optimal management.

Conclusions:

• Careful peri-operative evaluation and management are crucial for patients with IHD undergoing non-cardiac surgery.
• Anesthesiologists must be vigilant regarding the heightened risks, especially in patients with recent MI.
• Adherence to current practices and guidelines is essential for mitigating peri-operative complications.