[Management of patients with cardiovascular disease before and during anaesthesia (author's transl)]

The problems presented by persons with cardiovascular disease before and during anaesthesia are analysed. The physiology of the circulation is briefly dealt with; the role of cardiac rhythm, myocardiac contractility and peripheral vascular resistance in maintaining stable cardiovascular conditions and thereby ensuring an adequate blood supply to the tissues is reviewed. Causes, risks and treatment of cardiac arrhythmias are discussed with special reference to extrasystoles developing during anaesthesia. Anaesthesia for patients with a pace-maker is dealt with in detail. The advisability of pre-operative digitalization and means of treating acute cardiac arrest during anaesthesia are discussed. Therapeutic measures are suggested to counteract circulatory crises and acute rise of blood pressure during operation and to restore peripheral resistance to normal.