Perioperative myocardial infarction is a major cause of complicationsand death among patients undergoing noncardiac surgery.1 Annuallyin the United States, approximately 27 million patients aregiven anesthesia for surgical procedures; of these, approximately50,000 patients have a perioperative myocardial infarction.2The pathophysiology of an acute perioperative myocardial infarctionis probably the same as it is for infarction unrelated to surgery.3In patients with clinically significant coronary-artery stenosis,myocardial ischemia is induced either by a prolonged mismatchbetween oxygen demand and supply owing to the stress of surgeryor as the result of a sudden rupture of a vulnerable plaque. . . [Full Text of this Article]
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From the Departments of Anesthesiology (D.P.) and Cardiology (E.B.), Erasmus Medical Center, Rotterdam, the Netherlands.
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