Perioperative myocardial ischaemia and infarction in connection with cardiac and non-cardiac surgery

Although perioperative myocardial infarction has a relative low incidence, its occurrence is associated with a high morbidity and mortality. Although many single risk factors for developing a perioperative myocardial infarction have been described, it soon became apparent that surgical risk could hardly be determined by one single factor. A multifactorial approach for the preoperative assessment of patients at risk for developing cardiac complications in association with surgery and anesthesia was introduced. Further investigation, however, indicated that the risk of developing a perioperative myocardial infarction was not only determined by preoperative risk factors and a number of peroperative risk factors were also identified. Since identification of those patients, particularly at risk for developing a perioperative myocardial infarction, is a matter of prime importance in the choice of the treatment and the monitoring, a thorough understanding and knowledge of the different pre- and peroperative risk factors is a must for every surgeon and anesthetist