© 2002 by Heart
EDUCATION IN HEART
General cardiology
Anaesthesia and the cardiac patient: the patient versus the procedure
Correspondence to:
Correspondence to:
James B Froehlich MD, UMass Memorial Medical Center, University of Massachusetts Medical School, Division of Cardiovascular Medicine, University Campus, 55 Lake Avenue North, Worcester, MA 01655, USA;
froehlij@ummhc.org
Keywords: anaesthesia; coronary revascularisation; percutaneous coronary intervention; coronary bypass surgery
INTRODUCTION
For patients undergoing elective surgery, the most common cause of significant morbidity and mortality is occurrence of complications related to cardiac disease.1 It is estimated that approximately one million patients undergoing surgery each year in the USA suffer a perioperative myocardial infarction.1 This is particularly true for those with previous coronary disease and those facing higher risk surgery. Because of this fact, a great deal of research has focused on assessing cardiac risk before elective surgery. Less attention has been paid to methods of modifying the risk of cardiac complications attending surgery through medication use or other strategies. The risk of cardiac complications engenders a sense of conflict in that the patient perceives surgery as a threatening foe to be overcome: the patient versus the procedure. We would like to change that paradigm, and encourage an appreciation for the risk inherent to the patient, rather than to the
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Heart 2002 87: 280.
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