Frequency and significance of early postoperative silent myocardial ischemia in patients having peripheral vascular surgery

Pamela Ouyang, Gary Gerstenblith, William R. Furman, Peter J. Golueke, Sidney O. Gottlieb

Research output: Contribution to journalArticlepeer-review

Abstract

Coronary disease causes the majority of perioperative complications after peripheral vascular surgery. Twenty-four patients with stable coronary disease undergoing peripheral revascularization were studied using continuous electrocardiographic monitoring to determine the incidence of perioperative asymptomatic myocardial ischemia and its relation to postoperative clinical ischemic events. Patients were monitored preoperatively (17 ± 1 hours), intraoperatively and postoperatively (29 ± 2 hours) using 4-channel calibrated amplitude-modulated units. Fifteen patients (63%) had early postoperative silent ischemia; 3 also had preoperative silent ischemia and 5 intraoperative transient ischemia. Patients with and without silent ischemia had similar clinical characteristics, perioperative antianginal medications and postoperative episodes of hemodynamic instability. However, 8 of 15 patients (53%) with silent ischemia had postoperative clinical ischemic events (2 had myocardial infarction, 2 had new congestive heart failure and 4 had new rest angina), versus only 1 of 9 patients (11%) without silent ischemia who had angina (p < 0.05). Early postoperative silent myocardial ischemia occurs frequently after vascular surgery and is associated with postoperative clinical ischemic events.

Original languageEnglish (US)
Pages (from-to)1113-1116
Number of pages4
JournalThe American journal of cardiology
Volume64
Issue number18
DOIs
StatePublished - Nov 15 1989

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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