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[Symptomless (silent) myocardial ischemia and its prognostic significance]
Insights
Preoperative silent myocardial ischemia, detected via Holter monitoring (HM), indicates a higher risk of perioperative complications like heart attack and death following coronary revascularization surgery.
Area of Science:
- Cardiology
- Cardiovascular Surgery
Context:
- Silent myocardial ischemia (SMI) poses a risk for patients undergoing coronary revascularization.
- Perioperative complications, including myocardial infarction and mortality, are significant concerns in these procedures.
Purpose:
- To investigate the prognostic significance of preoperative silent myocardial ischemia.
- To correlate silent ischemia detected by Holter monitoring (HM) with perioperative complications.
Summary:
- Holter monitoring (HM) was conducted on 26 patients prior to coronary revascularization.
- 138 silent ischemic episodes were recorded in 7 patients during an average HM of 43 hours.
- Three perioperative myocardial infarctions occurred, one fatal, with 2 of 3 affected patients showing preoperative silent ischemia.
Impact:
- Preoperative silent myocardial ischemia is a significant predictor of adverse perioperative outcomes.
- Identifying SMI preoperatively can inform risk stratification and management strategies for coronary revascularization patients.
Abstract:
The authors studied the prognostic significance of Silent myocardial ischemia. To study the correlation between the silent ischemia before the operation of coronary revascularization and the perioperative complications (infarction, mortality) Holter-monitoring (HM) was performed with 26 patients. The average time of HM was 43 +/- 3.1 h. During the observation period total 138 silent ischemic episodes were registered with 7 patients. The average heart rate observed during the ischemic event did not differ from that observed in other periods. Three myocardial infarctions occurred in the perioperative period one of them was of lethal outcome. Silent ischemia was detected in 2 of 3 patients before operation. The patient who displayed the gravest ischemic alteration died of perioperative myocardial infarction. On the basis of their observations the authors attribute prognostic significance to the preoperative silent myocardial ischemia.