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[Risk factors and pathogenesis of postoperative cardiac decompensation (author's transl)]
Abstract:
In 214 patients with healed myocardial infarction an assessment was made of the prognostic value of risk factors relating to early postoperative cardiac decompensation which occurred in 50 cases. A significant influence was shown by age (greater than or equal to 75 years), pre-existing heart failure and load insufficiency, hypertension (greater than or equal to 180/95 mm Hg), advanced arteriosclerosis with cerebrovascular and renovascular symptoms, infections with fever or septicemia, emergency operations, lang-lasting surgery, decrease in blood pressure during operations (greater than or equal to 70 mm Hg systolic) and postoperative anemia (less than or equal to 3.5 millions erythrocytes/cmm). The postoperative cardiac failure took a lethal course in 60%. Pathogenetically, the discrepancy between O2-requirement and O2-supply in the previously damaged myocardium is of essential importance during the postoperative stress period.