Document Detail

The pathophysiology of peri-operative myocardial infarction.
MedLine Citation:
PMID:  20528842     Owner:  NLM     Status:  MEDLINE    
It is generally believed that plaque rupture and myocardial oxygen supply-demand imbalance contribute approximately equally to the burden of peri-operative myocardial infarction. This review critically analyses data of post-mortem, pre-operative coronary angiography, troponin surveillance, other pre-operative non-invasive investigations, and peri-operative haemodynamic predictors of myocardial ischaemia and/or myocardial infarction. The current evidence suggests that myocardial oxygen supply-demand imbalance predominates in the early postoperative period. It is likely that flow stagnation and thrombus formation is an important pathway in the development of a peri-operative myocardial infarction, in addition to the more commonly recognised role of peri-operative tachycardia. Research and therapeutic interventions should be focused on the prediction and therapy of flow stagnation and thrombus formation. Plaque rupture appears to be a more random event, distributed over the entire peri-operative admission.
B M Biccard; R N Rodseth
Publication Detail:
Type:  Journal Article; Review     Date:  2010-06-07
Journal Detail:
Title:  Anaesthesia     Volume:  65     ISSN:  1365-2044     ISO Abbreviation:  Anaesthesia     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-20     Completed Date:  2010-08-04     Revised Date:  2013-05-20    
Medline Journal Info:
Nlm Unique ID:  0370524     Medline TA:  Anaesthesia     Country:  England    
Other Details:
Languages:  eng     Pagination:  733-41     Citation Subset:  AIM; IM    
Department of Anaesthetics, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Inkosi Albert Luthuli Central Hospital, South Africa.
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MeSH Terms
Biological Markers / blood
Coronary Angiography
Coronary Circulation / physiology
Myocardial Infarction / etiology,  physiopathology*
Myocardial Ischemia / diagnosis
Postoperative Complications / physiopathology*
Preoperative Care / methods
Troponin / blood
Reg. No./Substance:
0/Biological Markers; 0/Troponin

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

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