Perioperative Myocardial Infarction

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Intraoperative Management• 100% O2 & Meds:BBCCBAlpha blockersVasodilators/nitratesGAS/NarcoticsLAAntiplt drugs• TEE, Cardiac enzymes, 12 lead (may be inaccurate)Sequential monitoring of cardiac troponin-I provides bestdetection intra and post op MI.
BETA BLOCKERS• BB: Use in high risk patients only w/ CAD or2+ cardiac risk factors Reduces morbidity, but not mortality Only 30% of pts prescribed benefit from therapy• Contraindicated: Asthma, COPD, Heartblocks, Severe LV dysfnx, Bradycardia
Page 1 and 2: PERIOPERATIVEMYOCARDIAL INFARCTION
Page 3 and 4: Objectives• Examine prevalence an
Page 8 and 9: Additional Risk factors• High ris
Page 11: Preoperative Assessment• Six step
Page 15 and 16: Intraoperative Diagnostics• Diagn
Page 18 and 19: Etiology• Surgically induced Proi
Page 20 and 21: Signs and Symptoms• Hemodynamic:
Page 22 and 23: Differential Diagnosis• MI may pr
Page 24: Intraoperative Prevention• Mainta
Page 29 and 30: Impending Cardiogenic Shock• Earl
Page 31 and 32: Postop Management• Catecholamine
Page 33 and 34: Conclusions• Anesthetists must be
Page 35 and 36: Forget everything already???• Loo
Page 37 and 38: REFERENCES• Adesanya, A., de Lemo
Page 39 and 40: REFERENCES• Barash, P. G., Cullen

Perioperative Myocardial Infarction

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