Document Detail

Peri-operative silent myocardial ischaemia in patients undergoing lower limb joint replacement surgery: an indicator of postoperative morbidity or mortality?
MedLine Citation:
PMID:  10364858     Owner:  NLM     Status:  MEDLINE    
One hundred and twenty-seven patients undergoing major lower limb joint replacement surgery were studied to determine the incidence of silent myocardial ischemia and to ascertain any link between pre-operative cardiac risk factors, silent myocardial ischaemia and postoperative morbidity. Patients underwent ambulatory ECG monitoring for 4 days (on the pre-operative night and for 3 days postoperatively). Postoperative cardiorespiratory symptomatology and morbidity was assessed by questionnaire at 3 months. Eighty-seven patients had risk factors for silent myocardial ischaemia; 42 patients (30 with risk factors) had peri-operative silent myocardial ischaemia. The median ischaemic loads (range) were 1.04 (0.32-13.31) min.h-1 pre-operatively and 5.53 (0.26-56.39), 6.69 (0.04-42.71) and 1.23 (0.1-53.74) min.h-1 on postoperative days 1-3, respectively. Risk factors did not predict the occurrence of silent myocardial ischaemia or an increased ischaemic load pre-operatively or overall postoperatively. New symptoms (chest pain, palpitations, breathlessness or fatigue) were associated with both silent myocardial ischaemia and ischaemic load (p < 0.05). Thus cardiac risk factors do not predict the occurrence of silent myocardial ischaemia or adverse outcome. Peri-operative silent myocardial ischaemia was associated with increased postoperative fatigue.
G W French; W H Lam; Z Rashid; J W Sear; P Foëx; S Howell
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anaesthesia     Volume:  54     ISSN:  0003-2409     ISO Abbreviation:  Anaesthesia     Publication Date:  1999 Mar 
Date Detail:
Created Date:  1999-06-23     Completed Date:  1999-06-23     Revised Date:  2009-09-29    
Medline Journal Info:
Nlm Unique ID:  0370524     Medline TA:  Anaesthesia     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  235-40     Citation Subset:  AIM; IM    
Nuffield Department of Anaesthetics, University of Oxford, John Radcliffe Hospital, Headington, UK.
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MeSH Terms
Arthroplasty, Replacement*
Electrocardiography, Ambulatory
Fatigue / etiology
Follow-Up Studies
Leg / surgery*
Middle Aged
Myocardial Ischemia / etiology*
Postoperative Complications*
Risk Factors
Treatment Outcome
Grant Support
//Wellcome Trust
Comment In:
Anaesthesia. 1999 Aug;54(8):817   [PMID:  10460545 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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