[Special problems of coronary patient: viewpoint of the anesthesiologist].
1) Patients with ischaemic heart disease have a substantial increased risk to develop perioperative myocardial infarction (reinfarction). 2) The incidence of cardiac complications increases when surgery is performed on the great vessels and in the intrathoracic and upper abdominal region. 3) The choice of the anaesthetic is of minor importance. However, isoflurane may be particularly susceptible to produce a coronary steal phenomenon and therefore should be used with caution in patients with IHD. 4) Experience and skill of the anaesthetist is of greater importance to avoid ischaemia. Invasive monitoring and aggressive treatment of haemodynamic disorders may reduce the risk of ischaemia. 5) During recovery patients with IDH must be controlled carefully at a recovery ward or ICU. 6) Preoperative evaluation of the individual risk and specific treatment of haemodynamic and metabolic disorders are mandatory. Psychologic guidance of the patients throughout the preoperative period is important.
Kettler
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Zentrum Anaesthesiologie der Universität, Göttingen.
D000768:Anesthesia, General; D003327:Coronary Disease / Q000503:physiopathology*; D006321:Heart / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D007431:Intraoperative Complications / Q000503:physiopathology; D009203:Myocardial Infarction / Q000503:physiopathology; D012307:Risk Factors
Spezialproblem Coronarpatient: Sicht des Anaesthesisten.