[Diagnosis of perioperative myocardial infarction within the first seventy-two hours after cardiac surgery].
One of the most frequent complications of cardiac surgery is the perioperative myocardial infarction (PMI). Incidence of PMI shows a wide variation because an accurate detection of this complication is difficult in the early postoperative stage. The objectives of the present study were to determine in our population of patients the incidence of PMI during the first seventy two hours after cardiac surgery as well as associations among the accepted criteria to diagnose this complication.


METHODS
One hundred sixty four adults patients undergoing elective cardiac surgery were studied. With baselines preoperative studies, serial electrocardiographic, enzymatic [(determination of serum creatine kinase isoenzyme (CK-MB)] and echocardiographic studies were performed during the first 72 hours after cardiac surgery. Diagnosis of PMI was established with two or all the three positive criteria [electrocardiographic (ECG), enzymatic (CK-MB) and echocardiographic (ECHO)].


RESULTS
In 24 (15%) patients PMI was diagnosed. In this group 13 (54%) all the three criteria were positive. In 8 (33%) patients CK-MB and ECHO were positive. In 3 (13%) patients CK-MB and ECG were positive.


CONCLUSIONS
In our population the incidence of PMI (15%) is agree with the reported in previous studies. In most of cases of PMI all the three diagnostic criteria are positive. When diagnosis is established only with two criteria, in most of cases these are CK-MB and ECHO.
Díaz-Arrieta
Gustavo
G
Medico cardiólogo adscrito a la Unidad de Terapia Intensiva Postquirúrgica Cardiovascular, México. gustavodiazarrieta@yahoo.com
Rincón-Salas
José de Jesús
Jde J
Reyes-Sánchez
María Elena
ME
Urzua-Zamarripa
Marisela
M
Mendieta-Tapia
Juan Carlos
JC
Mendoza-Hernández
María Elsa
ME
Valenzuela-Molina
Lucía Concepción
LC
Jiménez-Lomas
Sofía
S
Sánchez-Velázquez
Luis David
LD
Amador-Santander
José Fernando
JF
Vázquez-Pavón
Laura
L
Méndez-Lucero
René
R
Venegas-Alvarez
David
D
Ambriz-Nava
Luis Pedro
LP
Ortega-Alvarado
Silvia Alejandra
SA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D013997:Time Factors; D055815:Young Adult