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Diastolic dysfunction - What an anesthesiologist needs to know?

Aidan Sharkey1, Feroze Mahmood1, Robina Matyal1

  • 1Department of Anesthesia Critical Care and Pain Management, Beth Israel Deaconess Medical Center, Harvard Medical School, One Deaconess Road, Boston, MA, 02215, USA.

Best Practice & Research. Clinical Anaesthesiology
|October 5, 2019
PubMed
Summary
This summary is machine-generated.

Diastolic dysfunction (DD) is common in surgery patients. This review offers anesthesiologists a practical guide to diagnosing and managing DD perioperatively, addressing limitations of current guidelines.

Keywords:
diastolic dysfunctionheart failureperioperative outcomestransesophageal echocardiography

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Area of Science:

  • Anesthesiology
  • Cardiology
  • Critical Care Medicine

Background:

  • Diastolic dysfunction (DD) is increasingly prevalent in surgical patients due to aging populations and improved diagnostics.
  • Existing guidelines for DD diagnosis are not directly applicable to the perioperative setting.
  • Understanding DD pathophysiology, diagnosis, and management is crucial for anesthesiologists.

Purpose of the Study:

  • To review the grading of diastolic dysfunction.
  • To present a practical approach for diagnosing and managing DD in the perioperative period.
  • To equip anesthesiologists with knowledge for optimizing care in patients with DD.

Main Methods:

  • Literature review of diastolic dysfunction.
  • Discussion of transthoracic echocardiogram (TTE) limitations in perioperative DD assessment.
  • Development of a practical diagnostic and management strategy for perioperative DD.

Main Results:

  • Diastolic dysfunction poses significant risks for adverse perioperative outcomes.
  • Current DD guidelines based on transthoracic echocardiogram (TTE) are insufficient for perioperative care.
  • A practical, perioperative-focused approach to DD diagnosis and management is needed.

Conclusions:

  • Anesthesiologists require specialized knowledge for managing perioperative diastolic dysfunction.
  • A tailored approach to DD diagnosis and management is essential during the perioperative period.
  • This review provides a framework for addressing DD in surgical patients.