Perioperative Acute Myocardial Infarction and Ischemia After Noncardiac Surgery: Pathophysiology, Prevention, and Nursing Implications

ABSTRACT Perioperative acute myocardial infarction (AMI) after noncardiac surgery increases the mortality rate of patients who experience it. Depending on the definition of AMI used and the patient population studied, perioperative AMI occurs in 0.01% to 10% of patients. Most instances of perioperat...

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Bibliographic Details
Published in:AORN journal 2022-12, Vol.116 (6), p.517-531
Main Author: Harris, David E.
Format: Article
Language:English
Subjects:
Biomarkers
Blood clots
Cardiac arrhythmia
cardiac biomarkers
cardiac troponin
Cardiovascular disease
Clinical practice guidelines
Coronary vessels
Cytokines
Disease prevention
Electrocardiography
Health risks
Heart attacks
Hemodynamics
Hypertension
Hypotension
Ischemia
Mortality
myocardial injury after noncardiac surgery (MINS)
myocardial ischemia
Pathophysiology
Patients
perioperative acute myocardial infarction (AMI)
Postoperative period
Proteins
Surgery
Thrombosis
Veins & arteries
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Summary:ABSTRACT Perioperative acute myocardial infarction (AMI) after noncardiac surgery increases the mortality rate of patients who experience it. Depending on the definition of AMI used and the patient population studied, perioperative AMI occurs in 0.01% to 10% of patients. Most instances of perioperative AMI occur within the first two days after surgery, do not present with classic myocardial infarction symptoms, and are the result of myocardial oxygen supply versus oxygen demand mismatch. Older patients; those with preexisting cardiovascular conditions; those undergoing thoracic, upper abdominal, or major vascular procedures; and those who experience perioperative hemodynamic instability are at particular risk. This article provides a clinically based review of the pathophysiology, perioperative risks, treatment options, outcomes, and nursing implications of perioperative AMI and ischemia. It provides evidence to assist perioperative nurses with meeting the physiologic and safety needs of their patients and highlights the evolving scientific understanding and clinical guidelines to promote current practice.
ISSN:0001-2092
1878-0369
DOI:10.1002/aorn.13826