This review highlights the importance of thorough peri-operative evaluation and management for patients with ischemic heart disease undergoing non-cardiac surgery to mitigate risks of myocardial ischemia and infarction.
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Emphasizes guideline-based peri-operative care in IHD; leaves open need for updated RCTs on risk tools.
The incidence of ischaemic heart disease (IHD) is increasing. The patients with IHD with or without interventions coming for non-cardiac surgical procedures are also increasing. These patients have increased risk of myocardial ischaemia, myocardial infarction (MI), conduction disturbances, morbidity and mortality during the peri-operative period. The risks of these events are even higher in patients with recent MI. An anaesthesiologist should be aware of the pathophysiology and the need to thoroughly evaluate the patient for peri-operative management. We searched Pubmed using combinations of terms like "ischemic heart disease" and "anaesthesia", "perioperative", and "anaesthetic implications". We reviewed the current practices and guidelines regarding evaluation, risk stratification and management.
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Hedge et al. (2017) studied this question.
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