Key Points 1. Major adverse cardiac events (MACEs) are relatively common in patients undergoing noncardiac surgical procedures. The incidence of perioperative myocardial infarction (PMI) is about 0.9%. However, a larger percentage of patients experiences a perioperative increase in cardiac troponins…
Key Points 1. Cerebrovascular accidents are some of the most significant perioperative complications because they increase long-term disability, hospital length of stay, and mortality. 2. Recent stroke is associated with a 1.8-fold increased risk of death in noncardiac surgery. 3.…
Key Points 1. The postanesthesia care unit (PACU) is a specialized unit designed to monitor for early postanesthesia and surgical adverse events. 2. Early cardiac decline after noncardiac surgery requires prompt evaluation, early intervention, and cardiologist consultation for advanced care.…
Key Points 1. The costs of healthcare are escalating. Goal-directed fluid therapy (GDT) and multimodal pain relief are ways to control cost while improving quality. 2. GDT is an integral part of enhanced recovery programs (ERPs), as is multimodal pain…
Key Points 1. The rate of maternal heart disease is increasing and complicates up to 4% of pregnancies. It is a leading cause of maternal, fetal, and neonatal morbidity and mortality. 2. The diagnosis of new cardiovascular disease during pregnancy…
Key Points 1. Cardiomyopathy and ischemic coronary artery disease are the most common cardiac conditions in liver transplant candidates. 2. There are no clear recommendations for the assessment of cardiac status before liver transplantation, but each patient must be individually…
Key Points 1. Cardiac patients presenting for emergency noncardiac surgery have higher risk for perioperative morbidity and mortality. Emergency surgeries are associated with two to five times the risk of major adverse cardiac events compared with elective procedures. Preoperative evaluation…
Key Points 1. Tachyarrhythmias result from one of three mechanisms (reentry, automaticity, and triggered activity), with reentry being the mechanism most commonly treated in the electrophysiology (EP) laboratory. 2. Anesthetic agents influence cardiac conduction and arrhythmogenesis and can adversely affect…
Key Points 1. Cardiac patients and those who have had previous cardiac surgery often present for intrathoracic diagnostic or therapeutic noncardiac procedures. 2. Patients with coronary artery disease, valvular heart disease, cardiomyopathies, or pulmonary hypertension may require surgery involving lung…
Key Points 1. Patients who present for cerebrovascular, aortic, or peripheral arterial interventions are at elevated risk for concomitant coronary artery disease. 2. A thorough preoperative assessment for cardiovascular disease and medical optimization of any comorbid conditions are essential before…