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Myocardial Ischaemia

  • G. M. Woerlee
Part of the Developments in Critical Care Medicine and Anesthesiology book series (DCCA, volume 18)

Abstract

Ischaemia is defined as a condition of tissue oxygen deprivation secondary to reduced tissue blood flow. Any situation in which the coronary blood flow is inadequate to supply the contracting myocardium with sufficient oxygen will cause myocardial ischaemia. If myocardial ischaemia is prolonged, myocardial infarction with all its consequences will occur. Angina pectoris, ST-segment, T-wave changes and ventricular arrhythmias are all evidence of myocardial ischaemia.

Keywords

Myocardial Ischaemia Mean Arterial Blood Pressure Coronary Blood Flow Coronary Circulation Myocardial Oxygen Consumption 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Kennedy,J.W., et al. (1980). Multivariate discriminant analysis of the clinical and angiographic predictors of operative mortality from the Collaborative Study in Coronary Artery Surgery. JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 80, 876–887.PubMedGoogle Scholar
  2. 2.
    Goldman,L., et al. (1978). Cardiac risk factors and complications in non-cardiac surgery. MEDICINE, 57, 357–370.PubMedCrossRefGoogle Scholar
  3. 3.
    Slogoff,S., Keats,A.S. (1985) Does Perioperative Ischaemia Lead to Postoperative Myocardial Infarction? ANESTHESIOLOGY, 62, 107–114.PubMedCrossRefGoogle Scholar
  4. 4.
    Rao,T.L.K., et al. (1983) Reinfarction Following Anaesthesia in Patients with Myocardial Infarction. ANESTHESIOLOGY, 59, 499–505.PubMedCrossRefGoogle Scholar
  5. 5.
    Wynands,J.E. (1982) Anaesthesia for cardiac patients having non-cardiac operations. CANADIAN ANAESTHETISTS’ SOCIETY JOURNAL, 29, 341–348.PubMedCrossRefGoogle Scholar
  6. 6.
    Thomson,I.R., et al. (1984). Failure of Intravenous Nitroglycerin to Prevent Intraoperative Myocardial Ischaemia during Fentanyl-Pancuronium Anaesthesia. ANESTHESIOLOGY, 61, 385–393.PubMedCrossRefGoogle Scholar
  7. 7.
    Fusciardi,J., et al. (1986). Roles of Fentanyl and Nitroglycerin in Prevention of Myocardial Ischaemia Associated with Laryngoscopy and Tracheal Intubation in Patients Undergoing Operations of Short Duration. ANESTHESIOLOGY, 65, 617–624.CrossRefGoogle Scholar
  8. 8.
    Reiz,S., et al. (1985). Coronary Haemodynamic Effects of Surgery during Enflurane — Nitrous Oxide Anaesthesia in Patients with Ischaemic Heart Disease. ACTA ANAESTHESIOLOGICA SCANDINAVICA, 29, 106–112.PubMedCrossRefGoogle Scholar
  9. 9.
    Lieberman,R.W., et al. (1983). Hemodynamic Predictors of Myocardial Ischaemia during Halothane Anesthesia for Coronary Artery Revascularization. ANESTHESIOLOGY, 59, 36–41.PubMedCrossRefGoogle Scholar
  10. 10.
    Prys-Roberts,C. (1984). Anaesthesia and Hypertension. BRITISH JOURNAL OF ANAESTHESIA, 56, 711–723.CrossRefGoogle Scholar
  11. 11.
    Rifkin, R.D., Hood, W.B. (1977). Bayesian analysis of electrocardiographic exercise stress testing. NEW ENGLAND JOURNAL OF MEDICINE, 297, 681–686.PubMedCrossRefGoogle Scholar
  12. 12.
    Roy,W.L., et al. (1979). Myocardial ischaemia during non-cardiac surgical procedures in patients with coronary-artery disease. ANESTHESIOLOGY, 51, 393–397.PubMedCrossRefGoogle Scholar
  13. 13.
    Kaplan,J.A., King,S.B. (1976). The precordial electrocardiographic lead (V5) in patients who have coronary artery disease. ANESTHESIOLOGY, 45, 570–574.PubMedCrossRefGoogle Scholar
  14. 14.
    Bazaral,M.G., Norfleet,E.A. (1981). Comparison of CB5 and V5 leads for intraoperative electrocardiographic monitoring. ANESTHESIA AND ANALGESIA, 60, 849–853.PubMedCrossRefGoogle Scholar
  15. 15.
    Loeb,H.S., et al., (1978), Effects of pharmacologically induced hypertension on myocardial ischaemia and coronary haemodynamics in patients with fixed coronary obstruction. CIRCULATION, 57, 41–46.PubMedGoogle Scholar
  16. 16.
    Hofrman, J.I.E., (1987), A critical view of coronary reserve. CIRCULATION, 75, supp. I., 6–11.Google Scholar
  17. 17.
    Kissin,I., et al, (1980), Is the rate pressure product a misleading guide? ANESTHESIOLOGY, 52, 373–374.PubMedCrossRefGoogle Scholar
  18. 18.
    Reves,J.G., et al., (1979), Violation of RPP exercise threshold in coronary patients. ANESTHESIOLOGY, 51, s64.Google Scholar
  19. 19.
    Mosher,P., et al., (1964), Control of coronary blood flow by an autoregulatory mechanism. CIRCULATION RESEARCH, 14, 250–259.PubMedGoogle Scholar
  20. 20.
    Bache, R.J., Schwarz, J,S., (1982), Effect of perfusion pressure distal to a coronary stenosis on transmural myocardial blood flow. CIRCULATION, 65, 928–935.PubMedCrossRefGoogle Scholar
  21. 21.
    Hoffman,J.I.E., (1978), Determinants and prediction of transmural myocardial perfusion. CIRCULATION, 58, 381–391.PubMedGoogle Scholar
  22. 22.
    Hillis,L.D., Braunwald,E., (1977), Myocardial ischaemia. (First of three parts). NEW ENGLAND JOURNAL OF MEDICINE, 296, 971–978.PubMedCrossRefGoogle Scholar
  23. 23.
    Janse,M.J., Kleber,A.G., (1981), Electrophysiological changes and ventricular arrhythmias in the early phase of regional myocardial ischaemia. CIRCULATION, 49, 1069–1081.Google Scholar
  24. 24.
    Downar,E., et al., (1977), The effect of acute coronary artery occlusion on subendocardial transmembrane potentials in the intact porcine heart. CIRCULATION, 56, 217–224.PubMedGoogle Scholar
  25. 25.
    Noakes,T.D., et al., (1983), Physical training increases ventricular fibrillation thresholds of isolated rat hearts during normoxia, hypoxia and regional ischaemia. CIRCULATION, 67, 24–30.PubMedCrossRefGoogle Scholar
  26. 26.
    Amsterdam,E., (1973), Function of the hypoxic myocardium. Experimental and clinical aspects. AMERICAN JOURNAL OF CARDIOLOGY, 32, 461–471.PubMedCrossRefGoogle Scholar
  27. 27.
    Hearse,D.J., (1979), Oxygen depivation and early myocardial contracile failure: A reassessment of the possible role of adenosine triphosphate. AMERICAN JOURNAL OF CARDIOLOGY, 44, 1115–1121.PubMedCrossRefGoogle Scholar
  28. 28.
    Kubler,W., Kat,Z.A.M., (1977), Mechanism of early “pump” failure of the ischaemic heart: Possible role of adenosine triphosphate depletion and inorganic phosphate accumulation. AMERICAN JOURNAL OF CARDIOLOGY, 40, 467–471.PubMedCrossRefGoogle Scholar
  29. 29.
    Katz,A.M., (1973), Effects of ischaemia on the contractile processes of heart muscle. AMERICAN JOURNAL OF CARDIOLOGY, 32, 456–460.PubMedCrossRefGoogle Scholar
  30. 30.
    Parker,J.O., et al., (1969), Reversible cardiac failure during angina pectoris. Hemodynamic effects of atrial pacing in coronary artery disease. CIRCULATION, 39, 745–757.PubMedGoogle Scholar
  31. 31.
    Bay,J., et al., (1968), Factors influencing arterial PO2 recovery from anaesthesia. BRITISH JOURNAL OF ANAESTHESIA, 40, 398–407.PubMedCrossRefGoogle Scholar

Copyright information

© Kluwer Academic Publishers 1988

Authors and Affiliations

  • G. M. Woerlee
    • 1
  1. 1.Department of AnaesthesiaUniversity Hospital of LeidenThe Netherlands

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