Perioperative management of the patient with cardiac disease.
The overall incidence of perioperative death is relatively low. However, patients with coronary artery disease are at higher than average risk of perioperative cardiac complications. Thus, preoperative testing for cardiac disease should be done in certain patients in an effort to reduce postoperative mortality and morbidity. Patients who require emergent orthopaedic surgery are at greater risk of perioperative cardiac events than are those who undergo elective procedures. Certain modalities, such as beta blockers, statins, and alpha-2 agonists, may be started or continued in the postoperative period to further enhance cardiac function. We review the current recommendations for preoperative cardiac testing in orthopaedic patients and for perioperative management of orthopaedic patients with known cardiac disease.
Decker
Robert C
RC
Department of Orthopaedic Surgery, Emory University, Atlanta, GA, USA.
Foley
Jennifer R
JR
Moore
Thomas J
TJ
D058669:Adrenergic alpha-2 Receptor Antagonists; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000465:Algorithms; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000628:therapy*; D005080:Exercise Test; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D019990:Perioperative Care; D011182:Postoperative Care; D011183:Postoperative Complications; D018570:Risk Assessment
D058669:Adrenergic alpha-2 Receptor Antagonists; D000319:Adrenergic beta-Antagonists; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors