Cardiopatía Isquémica y Anestesia
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Transcript of Cardiopatía Isquémica y Anestesia
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Anestesia
Cardiopatía Isquémica
Presenta:
Toluca, Agosto 2017
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Objetivos
• Definición de cardiopatía Isquémica
▫ Descripción del Espectro Clinico
• Valoración Preanestésica
• Manejo Perioperatorio
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Definición
Enfermedad Arterial Coronaria
Balance: VO2/DO2
PPC: PAM – PTDVI
Journal of the American College of Cardiology 39 (2): 210–218
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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
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Cardiopatía Isquémica
Kristian Thygesen et al. Circulation. 2012;126:2020-2035
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▫ …
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
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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
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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
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Medicación Preoperatoria
• Beta Bloqueadores (FC meta)
• Esta tinas
• ASA
• IECAS
Miller's Anesthesia, 2-Volume, 8th Edition
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Gabinete Preoperatorio
• ECG
• Radiografía de Tórax
• Ecocardiograma
• Prueba de Esfuerzo
Miller's Anesthesia, 2-Volume, 8th Edition
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Marcapasos
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Manejo Anestésico
• Conservar VO2/DO2
• Controlar determinantes de GC
• Monitorización
▫ LA, PVC, PAP, Swan Ganz.
Miller's Anesthesia, 2-Volume, 8th Edition
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Gracias!!!