Recent case...

[Noyac]

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1 I'm only pointing it out for the residents.

I figured but I'm either too old to know of this or I forgot it. I'm just pointing out that in my experience the riskiest time for perioperative MI is a coup,e days postop. Do you have any recent literature on this?

 

[Vaporized]

Wow.

As far as MI I have been getting taught 24-48h. Here is a link after a quick Google. I am sure there are better ones.

http://m.circ.ahajournals.org/content/119/22/2936.long

 

[urge]

Textbook of Cardiovascular Medicine

Eric J. Topol, Robert M. Califf
Lippincott Williams & Wilkins, 2007

Traditionally, MI was defined by the World Health Organization criteria, ECG criteria, and cardiac enzymes. Defining PMI, however, is often difficult because most PMIs occur without symptoms in anesthetized or sedated patients, ECG changes are subtle and/or transient, and the creatine kinase-MB isoenzyme has limited sensitivity and specificity because of coexisting skeletal muscle injury.8 Consequently, PMI was often recognized late (postoperative day 3 to 5), resulting in high (30% to 70%9) mortality.

http://m.circ.ahajournals.org/content/119/22/2936.long

The day 3 concept is a failure to recognize them early.

 

[TrishPish]

Good case and discussion points!