The utilization of automated ST segment analysis in the determination of myocardial ischemia.
Perioperative cardiac morbidity is a recognized complication of anesthesia and surgery. Morbidity includes myocardial infarction, new onset of unstable angina, congestive heart failure, and arrhythmias. Almost one third of all patients undergoing noncardiac surgery may be at increased risk of cardiac complications by virtue of age, coronary artery disease (CAD), or presence of two or more risk factors for CAD. Although postoperative ischemia has been identified as a significant risk factor for morbidity, automated ST segment analysis systems available with the new generation bedside monitors have not been used to identify ischemic episodes in patients recovering from anesthesia. Twenty-eight patients, age 41 to 80 years, were monitored in the postanesthesia care unit for ST segment changes (mean monitoring period, 97 minutes). Four patients had ischemic episodes from 7 to 44 minutes, and two of these patients had subsequent postoperative morbidity. All episodes were clinically silent. Automated ST segment analysis is an easily used technology that shows promise as a means of early detection of clinically silent perioperative myocardial ischemia.
Hewer
I
I
University of California, San Francisco, USA.
Drew
B
B
Karp
K
K
Stotts
N
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004562:Electrocardiography / Q000592:standards*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000209:etiology; D009719:Nurse Anesthetists; D016528:Postanesthesia Nursing; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology; D015203:Reproducibility of Results; D012307:Risk Factors