Myocardial ischemia detected by transesophageal echocardiography in a patient undergoing peripheral vascular surgery

• Published in: Journal of clinical anesthesia Vol. 12; no. 6; pp. 491 - 497
• Main Authors: Corda, David M, Caruso, Lawrence J, Mangano, Dennis
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.09.2000; Elsevier Science
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Bundle-Branch Block - diagnosis; Echocardiography, Transesophageal; elderly; Electrocardiography; Electrocardiography. Vectocardiography; Electrodiagnosis. Electric activity recording; Female; Humans; Hypertrophy, Left Ventricular - diagnosis; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Myocardial Infarction - diagnosis; Myocardial Infarction - diagnostic imaging; Myocardial ischemia; perioperative; Peripheral Vascular Diseases - surgery; peripheral vascular surgery; Risk Factors; transesophageal echocardiography; perioperative; Myocardial ischemia; transesophageal echocardiography; peripheral vascular surgery; female; elderly; Human; Cardiovascular disease; General anesthesia; Exploration; Intraoperative; Coronary heart disease; Myocardial disease; Arterial disease; Vascular disease; Case study; Electrodiagnosis; Treatment; Ischemia; Surgery; Electrocardiography; Myocardium; Occlusive arterial disease; Complication; Diagnosis; Esophageal route; Monitoring
• ISSN: 0952-8180; 1873-4529
• DOI: 10.1016/S0952-8180(00)00200-2

Prevention and early treatment of myocardial ischemia remain among the primary goals of the anesthesiologist taking care of high-risk patients, such as those undergoing vascular surgery. Guidelines have been published to assist in directing preoperative evaluation and optimization of cardiovascular status. Although perioperative monitoring allows early detection of ischemic events, all monitors have limitations that must be understood before they can be used effectively. We present a case of severe intraoperative myocardial dysfunction detected only by transesophageal echocardiography in a patient undergoing a peripheral vascular procedure. Preoperative and intraoperative management is also discussed.