Asymptomatic Cardiac abnormality in Patients Undergoing Low to Intermediate Risk Elective Noncardiac Surgery, Is it a Relevant Clinical Dilemma? | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 303, Volume 90, Issue 2, January 2023, Page 3523-3528 PDF (146.64 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2023.291963 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Hazem Mansour   ; Ahmed El-Sayed Ali Darwish; Mona Rayan; Ahmed Ibrahim El Desoky khalil
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| cardiology department, Faculty of Medicine, Ain shams university, Cairo-Egypt | ||||
| Abstract | ||||
| Background: Preoperative cardiovascular problems might be an important cause for morbidity and mortality in individuals undergoing noncardiac surgery. One patient from every 33 hospitalizations is exposed for noncardiac surgery major cardiovascular and cerebrovascular problems such as mortality, myocardial infarction, or stroke. Objective: The aim of the current work was to uncover hidden cardiac problems that may cause complications during and after low to intermediate elective noncardiac surgeries. Patients and Methods: This prospective, observational, cross-sectional study included a total of 250 asymptomatic adult patients referred to Department of Cardiology, Ain Shams University Hospitals for preoperative cardiac assessment before undergoing low to intermediate risk noncardiac surgery. Results: Most of the study group were males (68%) with a mean age of 47.1+15.5 years. Diabetes and hypertension were found in 45% and 41% of patients respectively. Most patients had gastrointestinal tract (GIT) operations (34%) followed by cataract extractions (14%), orthopedic operations were done in 11% of patients. Clinical examination was normal in 97.2% of patients whereas 2% of patients had atrial fibrillation (AF), 0.8% had systolic murmur. Significantly abnormal electrocardiogram (ECG) was found in 10% of patients. Preoperative significantly abnormal transthoracic echocardiography (TTE) was detected in 9% of patients. Post-operative cardiovascular complications occurred in 7% of patients who had completely normal preoperative clinical, ECG and echocardiographic data. Most of these patients had orthopedic operations and hysterectomy. Conclusion: It could be concluded that the clinical and predictive value of routine preoperative ECG and echocardiography for major cardiac adverse events in low-risk patient undergoing low to intermediate risk surgery is limited. However, it helps uncovering of hidden conditions that may alter patient's plan of treatment. The type of surgery might be an important factor for occurrence of post-operative complications in low-risk groups. | ||||
| Keywords | ||||
| Preoperative assessment; Asymptomatic patients; Noncardiac operation; ECG; Echocardiography | ||||
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