Patient (condition)
 
Aliases:
Ischaemic heart disease
IHD
Coronary artery disease
cad

Topic aliases are alternate phrasings for a particular topic.


Flowchart for preoperative assessment for non-cardiac surgery from refl.in/hb

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ACC/ACC Procedure risk stratification.

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Table of the approximate Metabolic Equivalents (METS) for various daily activities from ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery refl.in/hb

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The six minute-walk-test-6mwt may be a suitable alternative to cardiopulmonary exercise ( CPT/ CPEX) testing in assessment of patients underoing non-cardiac surgery. "Patients walking >563 m in the 6MWT do not routinely require CPET; those walking <427 m should be referred for further evaluation. In situations of ‘clinical uncertainty’ (>427 but <563 m), the number of clinical risk factors and magnitude of surgery should be incorporated into the decision-making process" refl.in/kq

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ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery refl.in/4s

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Active cardiac conditions for which non-urgent surgery should be delayed and condition optimised: Acute coronary syndrome within 30 days; New, worsening, or decompensated heart failure (NYHA class IV); Significant arrhythmia; or severe valvular disease. refl.in/g9

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CARP trial 2004: Coronary artery revascularization in patients with stable CAD underoing vascular surgery does not improve long-term survival or provide short-term benefit refl.in/7v

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Monitor for coronary ischemia with a 5 electrode ECG EKG, five lead.

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Nov 28, 2011
Lead II and aVf pick up 80% of intraoperative ischaemic events. Misses posterior events.
Parecoxib/valdecoxib did not increase risk of adverse cardiovascular events in non-cardiac patients. Anaesthesia Analgesia 2009; 108:299-307

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At risk of myocardial ischaemia. Maintain mean arterial pressure at +/- 15% of baseline, & maintain low normal heart rate to prolong diastolic filling time

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