| Multimodal detection of perioperative myocardial ischemia. | |
| | |
MedLine Citation:
|
PMID: 16429887 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Cardiac anesthesiologists have the responsibility to detect myocardial ischemia in a timely manner, which can be a challenging task in the perioperative environment. Transesophageal echocardiography pulmonary artery catheterization, and electrocardiography are the 3 major methods available for monitoring perioperative ischemia. Echocardiography, the newest and most sophisticated method, has been shown to be highly sensitive for detecting ischemia associated with systolic dysfunction. Echocardiography can detect wall-motion abnormalities before electrocardiographic changes develop in patients who are likely to experience supply-mediated ischemia. Perioperative ischemia that occurs after bypass and is detected using transesophageal echocardiography has been found to be related to an adverse outcome. However, the use of echocardiography has some limitations, including the detection of abnormalities not induced by ischemia and the presence of ischemia in areas not visible in the view selected. Pulmonary artery catheterization can provide information about systolic dysfunction, diastolic dysfunction, and mitral regurgitation, but the sensitivity and safety of catheterization have been questioned. Electrocardiography can be a superb monitoring device as long as clinicians pay adequate attention to lead selection and placement, filter selection, and gain adjustment. The optimal monitoring approach should integrate all 3 available monitoring systems in order to increase the likelihood of detecting both supply- and demand-mediated ischemia. |
| | |
Authors:
|
Jonathan B Mark |
Related Documents
:
|
18021877 - Evaluation of myocardial ischemia after surgical repair of anomalous aortic origin of a... 3396177 - Cellular electrophysiological changes during ischemia in isolated, coronary-perfused ca... 23597607 - A systematic review and meta-analysis on primary percutaneous coronary intervention of ... 2078357 - Silent myocardial ischemia. how to diagnose? how to treat? 22859687 - En face view of the mitral valve: definition and acquisition. 3092847 - Influence of glyceryl trinitrate and nifedipine on coronary sinus blood flow and global... |
Publication Detail:
|
Type: Journal Article; Review |
Journal Detail:
|
Title: Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital Volume: 32 ISSN: 0730-2347 ISO Abbreviation: Tex Heart Inst J Publication Date: 2005 |
Date Detail:
|
Created Date: 2006-01-24 Completed Date: 2006-03-07 Revised Date: 2009-11-18 |
Medline Journal Info:
|
Nlm Unique ID: 8214622 Medline TA: Tex Heart Inst J Country: United States |
Other Details:
|
Languages: eng Pagination: 461-6 Citation Subset: IM |
Affiliation:
|
Department of Anesthesiology, Duke University Medical Center, and Anesthesiology Service, Veterans Affairs Medical Center, Durham, North Carolina 27705, USA. Mark0003@mc.duke.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Anesthesiology
/
methods* Catheterization, Central Venous Echocardiography, Transesophageal Electrocardiography Humans Myocardial Ischemia / diagnosis* Perioperative Care / methods* |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Tooth and lip responses to three commonly prescribed premolar extraction sequences: a review of rece...
Next Document: Management of systemic and pulmonary hypertension.