The Pregnant Patient With Cardiac Disease
Key Points 1. The rate of maternal heart disease is increasing and complicates up to 4% of pregnancies. It is a leading cause of maternal, fetal, and neonatal morbidity and…
Postoperative Care of the Critically Ill
Key Points 1. Cerebrovascular accidents are some of the most significant perioperative complications because they increase long-term disability, hospital length of stay, and mortality. 2. Recent stroke is associated with…
Cardiac Considerations During Orthotopic Liver Transplantation
Key Points 1. Cardiomyopathy and ischemic coronary artery disease are the most common cardiac conditions in liver transplant candidates. 2. There are no clear recommendations for the assessment of cardiac…
Management in the Postanesthesia Care Unit of Complications in Cardiac Patients
Key Points 1. The postanesthesia care unit (PACU) is a specialized unit designed to monitor for early postanesthesia and surgical adverse events. 2. Early cardiac decline after noncardiac surgery requires…
Anesthesia for Cardioversion and Electrophysiologic Procedures
Key Points 1. Tachyarrhythmias result from one of three mechanisms (reentry, automaticity, and triggered activity), with reentry being the mechanism most commonly treated in the electrophysiology (EP) laboratory. 2. Anesthetic…
General, Regional, or Monitored Anesthesia Care for the Cardiac Patient Undergoing Noncardiac Surgery
Key Points 1. With monitored anesthesia care, the stress response to surgery may not be adequately blocked, and the resulting tachycardia may aggravate the patient’s underlying cardiac disease. 2. A…
Cardiovascular Implantable Electronic Device Management in Noncardiac Surgery
Key Points 1. Active fixation leads can penetrate through structures (e.g., the thin-walled right atrium) during placement and present as pain, pneumomediastinum, or effusions. 2. Active rate modulation in cardiac…
Cardiovascular Pharmacology in Noncardiac Surgery
Key Points 1. Intraoperative hemodynamic instability may be associated with increased cardiovascular complications and represents one of the most common findings associated with mortality. 2. Phenylephrine can be used for…
Echocardiography in Noncardiac Surgery
Key Points 1. The portability, ease of use, and rapid diagnostic capability of transesophageal echocardiography (TEE) make it the diagnostic modality of choice during acute hemodynamic instability. 2. Qualitative analysis…
Cardiovascular Monitoring in Noncardiac Surgery
Key Points 1. Excellent cardiac and hemodynamic management is essential to achieving good outcomes in patients with cardiovascular disease, particularly those undergoing high-risk noncardiac surgery. 2. Much cardiovascular information can…
