Acute myocardial infarction as an incidental finding: reflections on the preanesthesia evaluation

A preoperative electrocardiogram in a 16-year-old boy scheduled for surgery for a fractured radius and mandibular condyle after a motorcycle accident showed signs of myocardial ischemia as an incidental finding. Coronary arteriography revealed complete occlusion of the anterior descending artery, co...

Full description

Saved in:
Bibliographic Details
Published inRevista española de anestesiología y reanimación Vol. 56; no. 5; p. 315
Main Authors Ruiz-Gimeno, J I, Femenía, F, Ausina, A, Barberá, M
Format Journal Article
LanguageSpanish
Published Spain 01.05.2009
Subjects
Accidents, Traffic
Acute Coronary Syndrome - diagnosis
Acute Coronary Syndrome - drug therapy
Acute Coronary Syndrome - etiology
Adolescent
Cardiovascular Agents - therapeutic use
Coronary Vessels - injuries
Diagnostic Tests, Routine - utilization
Electrocardiography - utilization
Fracture Fixation, Internal
Heart Injuries - complications
Heart Injuries - diagnosis
Humans
Incidental Findings
Male
Mandibular Condyle - injuries
Mandibular Fractures - therapy
Multiple Trauma
Nerve Block
Preoperative Care
Radius Fractures - surgery
Wounds, Nonpenetrating - complications
Online AccessGet more information

Cover

More Information
Summary:A preoperative electrocardiogram in a 16-year-old boy scheduled for surgery for a fractured radius and mandibular condyle after a motorcycle accident showed signs of myocardial ischemia as an incidental finding. Coronary arteriography revealed complete occlusion of the anterior descending artery, confirming a diagnosis of acute coronary syndrome with ST elevation, with no myocardial viability. As the patient's general condition was acceptable, to prevent severe functional sequelae, surgery was rescheduled for 17 days later. An axillary block was well tolerated at that time. While indiscriminate ordering of preoperative tests is not recommended in the literature, such testing continues to be practiced in many hospitals, possibly for reasons of organization and legal cover. In our case, the electrocardiogram made it possible to diagnose a severe lesion and adjust the anesthetic technique to suit this situation, thereby possibly preventing devastating consequences. We recommend performing an electrocardiogram on all patients with suspected blunt chest trauma, regardless of the severity of the lesions, particularly in patients scheduled for surgery.
ISSN:0034-9356