Conclusion
The overall incidence of CAD is decreasing in North America; the preventive, diagnostic and therapeutic measures have improved in the last decades as have progressed our knowledge of the disease. Despite these facts, the problem of the patient with CAD presenting for anaesthesia is still serious and likely to increase as the population ages. Therefore, the vigilant anaesthetist must seek out and protect patients at risk of developing periopera-tive MI.
Résumé
L’infarctus du myocarde (IM) peut survenir en période périopératoire comme en tout autre temps, et cette éventualité est encore plus grande chez les malades avec une histoire d’infarctus. Le taux de mortalité des IM périopératoires est élevé. Les incidents entourant l’inter-vention influencent la survenue et la gravité de ces infarctus. L’athérosclérose déjà installée est habituelle-ment le terrain sur lequel se greffe un thrombus etlou un vasospasme. L’ischémie myocardique résultant de certaines perturbations périopératoires peut conduire à un infarctus du myocarde.
Tous les adultes devant subir une chirurgie doivent être investigués en vue de la détection d’une maladie coronarienne, d’hypertension artérielle et de signes d’athérosclérose. Lorsqu’une pathologie coronarienne est pressentie, un monitoring approprié est nécessaire pour la période per et postopératoire. Tout indice d’infarctus périopératoire mérite une investigation poussée et l’in-farctus confirmé doit être traité vigoureusement pour en éviter les complications redoutables.
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Maillé, J.G., Boulanger, M., Dyrda, I. et al. Anaesthesia and myocardial infarction. Can Anaesth Soc J 33, 807–819 (1986). https://doi.org/10.1007/BF03027136
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DOI: https://doi.org/10.1007/BF03027136