Silent myocardial ischemia in patients undergoing peripheral vascular surgery: incidence and association with perioperative cardiac morbidity and mortality.


Journal Article

Atherosclerosis is a systemic disorder and coronary artery disease is highly prevalent in patients treated for lower-extremity obstructive vascular disease. Myocardial ischemia and infarction represent the most frequent and most clinically important complications of surgical procedures for lower-extremity revascularization. Despite attempts in several areas, no practical, sensitive, and specific method for identifying patients at highest risk for myocardial events postoperatively has been found before now. This study reports observations on a consecutive series of 50 patients who underwent continuous perioperative electrocardiographic monitoring with a microprocessor-based electrocardiographic ischemia monitor. Thirty-eight percent of the patients were found to have episodes of ischemia; most of these episodes were painless and would not otherwise have been recognized. Ischemia was most prominent in the postoperative rather than the preoperative or intraoperative phases. Tachycardia was often associated with ischemia. Significantly more cardiac-related morbidity and deaths occurred in patients who were documented to have silent myocardial ischemia. In fact, no cardiac events occurred in the 31 patients without ischemia (p less than 0.02). This type of ischemia monitoring represents a potential method for segregating patients at high risk for cardiac-related morbidity and death during lower-extremity revascularization.

Full Text

Duke Authors

Cited Authors

  • McCann, RL; Clements, FM

Published Date

  • April 1989

Published In

Volume / Issue

  • 9 / 4

Start / End Page

  • 583 - 587

PubMed ID

  • 2709527

Pubmed Central ID

  • 2709527

International Standard Serial Number (ISSN)

  • 0741-5214


  • eng

Conference Location

  • United States