The definition of myocardial infarction during aortocoronary bypass surgery.
In a study of 392 aortocoronary bypass (CABG) patients, we found 16 patients with a postoperative new Q wave, 29 patients with new intraventricular conduction disturbance, 17 patients with cardiogenic shock, and 14 patients with excessive CK-MB activity. Those criteria were considered as diagnostic of perioperative acute myocardial infarction (AMI). Listing the 392 patients in a Venn diagram: five patients had three positive criteria, eight had two, 43 had one, and 336 had none. Ventricular arrhythmia, supraventricular arrhythmia, or ST-T changes occurred in decreasing frequency in patients with a decreasing number of positive criteria. Five patients died postoperatively and in four a postmortem examination was available. Diagnostic criteria partly predicted autopsy findings. We conclude that the diagnostic criteria of perioperative myocardial infarction have a low diagnostic performance.
D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000503:physiopathology; D001026:Coronary Artery Bypass; D003402:Creatine Kinase / Q000097:blood; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis* / Q000201:enzymology; D012770:Shock, Cardiogenic / Q000209:etiology
D007527:Isoenzymes; D003402:Creatine Kinase