}

Anestesia

Cardiopatía Isquémica

Presenta:

Toluca, Agosto 2017

Objetivos

• Definición de cardiopatía Isquémica

▫ Descripción del Espectro Clinico

• Valoración Preanestésica

• Manejo Perioperatorio

Definición

Enfermedad Arterial Coronaria

Balance: VO2/DO2

PPC: PAM – PTDVI

Journal of the American College of Cardiology 39 (2): 210–218

Espectro EAC

• Angina Estable

Síndrome Isquémico

Coronario Agudo (SICA)

•Angina Inestable

•IAM SEST

•IAM CEST

Journal of the American College of Cardiology 39 (2): 210–218

Cardiopatía Isquémica

Kristian Thygesen et al. Circulation. 2012;126:2020-2035

▫ …

Valoración Preop.

Fleisher LA, Fleischmann KE, Auerbach AD. 2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing NoncardiacSurgery: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014. [Epub ahead of print].

Illustration used with the permission of Elsevier Inc. All rights reserved

Fleisher LA, Fleischmann KE, Auerbach AD. 2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing NoncardiacSurgery: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014. [Epub ahead of print].

Illustration used with the permission of Elsevier Inc. All rights reserved

Fleisher LA, Fleischmann KE, Auerbach AD. 2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing NoncardiacSurgery: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014. [Epub ahead of print].

Illustration used with the permission of Elsevier Inc. All rights reserved

Medicación Preoperatoria

• Beta Bloqueadores (FC meta)

• Esta tinas

• ASA

• IECAS

Miller's Anesthesia, 2-Volume, 8th Edition

Gabinete Preoperatorio

• ECG

• Radiografía de Tórax

• Ecocardiograma

• Prueba de Esfuerzo

Miller's Anesthesia, 2-Volume, 8th Edition

Marcapasos

Manejo Anestésico

• Conservar VO2/DO2

• Controlar determinantes de GC

• Monitorización

▫ LA, PVC, PAP, Swan Ganz.

Miller's Anesthesia, 2-Volume, 8th Edition

Gracias!!!