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Curr Opin Crit Care · Dec 2021
ReviewMyocardial injury after noncardiac surgery: facts, fallacies and how to approach clinically.
- Michelle S Chew and Christian Puelacher.
- Department of Anaesthesia and Intensive Care, Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
- Curr Opin Crit Care. 2021 Dec 1; 27 (6): 670-675.
Purpose Of ReviewAcute myocardial injury occurs commonly during perioperative care. There is still considerable confusion regarding its diagnosis and definition, and a lack of consensus on who and how to screen, exacerbated by a lack of studies addressing how to manage patients with detected myocardial injury.Recent FindingsFar from a benign biochemical anomaly, myocardial injury occurring perioperatively is largely a silent disease and is not necessarily because of ischaemia. Preoperative, postoperative, and perioperative changes in cardiac troponins (cTns) are independently associated with increased mortality and adverse cardiovascular outcomes. Routine screening with cTns is required for reliable detection of myocardial injury. Measurement of changes (from preoperative to postoperative) will detect acute events as well as identify patients with chronic troponin increases.SummaryThis review aims to bring together current literature regarding myocardial injury that is detected perioperatively, identifies knowledge gaps for future research and provides suggestions for management.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
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