Evaluación pre operatoria del paciente con cardiopatía isquémica, ya sea con diagnostico previo o de novo; consideraciones y cuidados anestésicos.

1. Anestesia
Cardiopatía Isquémica
Presenta:
Toluca, Agosto 2017

2. Objetivos
• Definición de cardiopatía Isquémica
▫ Descripción del Espectro Clinico
• Valoración Preanestésica
• Manejo Perioperatorio

3. Definición
Enfermedad Arterial Coronaria
Balance: VO2/DO2
PPC: PAM – PTDVI
Journal of the American College of Cardiology 39 (2): 210–218

4. 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

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

7. ▫ …
Valoración Preop.
Fleisher LA, Fleischmann KE, Auerbach AD. 2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac
Surgery: 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

8. Fleisher LA, Fleischmann KE, Auerbach AD. 2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac
Surgery: 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

9. Fleisher LA, Fleischmann KE, Auerbach AD. 2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac
Surgery: 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

10. Medicación Preoperatoria
• Beta Bloqueadores (FC
meta)
• Esta tinas
• ASA
• IECAS
Miller's Anesthesia, 2-Volume, 8th Edition

11. Gabinete Preoperatorio
• ECG
• Radiografía de Tórax
• Ecocardiograma
• Prueba de Esfuerzo
Miller's Anesthesia, 2-Volume, 8th Edition

12. Marcapasos

13. Manejo Anestésico
• Conservar VO2/DO2
• Controlar determinantes de GC
• Monitorización
▫ LA, PVC, PAP, Swan Ganz.
Miller's Anesthesia, 2-Volume, 8th Edition

14. Gracias!!!