Coronary vasomotion during anesthesia
Reiz, S.
Acta Chirurgica Scandinavica. Supplementum 550 63-70; Discussion: 71-73
1989
ISSN/ISBN: 0301-1860 PMID: 2652973 Document Number: 340989
The incidence of perioperative myocardial ischemia and associated cardiac complications in patients with coronary artery disease (CAD) varies widely, as reported in the literature. Much of the confusion and contradictions surrounding this issue can be attributed to differences in populations studied, study protocols, and techniques employed to diagnose myocardial ischemia and infarction. Data obtained in recent years have indicated that a large proportion of intraoperative myocardial ischemic events are unrelated to hemodynamic aberrations. Coronary vasospasm and blood flow redistribution have both been suggested as important mechanisms for ischemia during anesthesia and surgery in patients with CAD. These findings challenge our concepts of how ischemia might be prevented by maintaining systemic hemodynamics within "normal limits". They also emphasize the importance of establishing new and more sensitive methods to detect myocardial ischemia in the operating room and recovery area. This paper focuses on myocardial ischemia related to coronary vasomotion during anesthesia and surgery.