Saudi Journal of Anaesthesia

REVIEW ARTICLE
Year
: 2020  |  Volume : 14  |  Issue : 1  |  Page : 91--99

Perioperative myocardial injury and infarction following non-cardiac surgery: A review of the eclipsed epidemic


Rohan Magoon, Neeti Makhija, Devishree Das 
 Department of Cardiac Anaesthesia, Cardiothoracic Centre, CNC, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India

Correspondence Address:
Dr. Neeti Makhija
Department of Cardiac Anaesthesia, Cardiothoracic Centre, All India Institute of Medical Sciences, Room No. 9, 7th Floor, New Delhi - 110 029
India

The perioperative period induces unpredictable and significant alterations in coronary plaque characteristics which may culminate as adverse cardiovascular events in background of a compromised myocardial oxygen supply and demand balance. This “ischemic-imbalance” provides a substrate for perioperative cardiac adversities which incur a considerable morbidity and mortality. The propensity of myocardial injury is dictated by the conglomeration of various factors like pre-existing medical condition, high-risk surgical interventions, intraoperative hemodynamic management, and the postoperative care. Perioperative myocardial infarction (PMI) differs from myocardial infarction (MI) in a non-operative setting. PMI can often be notoriously ̶silent” demonstrating a conspicuous absence of the classic clinical symptoms. Moreover, myocardial injury following non-cardiac surgery (MINS) characterized by an elevation of the cardiac insult biomarkers has demonstrated an independent prognostic significance in the perioperative scenario despite the lack of a formal categorization as PMI. This has evoked interest in the meticulous characterization of MINS as a discrete clinical entity. Multifactorial etiology, varying symptomatology, close differential diagnosis, and a debatable management regime makes perioperative myocardial injury-infarction, a subject of detailed discussion.


How to cite this article:
Magoon R, Makhija N, Das D. Perioperative myocardial injury and infarction following non-cardiac surgery: A review of the eclipsed epidemic.Saudi J Anaesth 2020;14:91-99


How to cite this URL:
Magoon R, Makhija N, Das D. Perioperative myocardial injury and infarction following non-cardiac surgery: A review of the eclipsed epidemic. Saudi J Anaesth [serial online] 2020 [cited 2020 Sep 29 ];14:91-99
Available from: http://www.saudija.org/article.asp?issn=1658-354X;year=2020;volume=14;issue=1;spage=91;epage=99;aulast=Magoon;type=0