Diagnóstico de infarto miocárdico perioperatorio dentro de las primeras 72 horas posteriores a la cirugía cardiaca / Diagnosis of perioperative myocardial infarction within the first seventy-two hours after cardiac surgery

ABSTRACT

One of the most frequent complications of cardiac surgery is the perioperative myocardial infarction (PMI). Incidence of PMI shows a wide variation because an accurate detection of this complication is difficult in the early postoperative stage. The objectives of the present study were to determine in our population of patients the incidence of PMI during the first seventy two hours after cardiac surgery as well as associations among the accepted criteria to diagnose this complication. PATIENTS AND METHODS: One hundred sixty four adults patients undergoing elective cardiac surgery were studied. With baselines preoperative studies, serial electrocardiographic, enzymatic [(determination of serum creatine kinase isoenzyme (CK-MB)] and echocardiographic studies were performed during the first 72 hours after cardiac surgery. Diagnosis of PMI was established with two or all the three positive criteria [electrocardiographic (ECG), enzymatic (CK-MB) and echocardiographic (ECHO)]. RESULTS: In 24 (15%) patients PMI was diagnosed. In this group 13 (54%) all the three criteria were positive. In 8 (33%) patients CK-MB and ECHO were positive. In 3 (13%) patients CK-MB and ECG were positive. CONCLUSIONS: In our population the incidence of PMI (15%) is agree with the reported in previous studies. In most of cases of PMI all the three diagnostic criteria are positive. When diagnosis is established only with two criteria, in most of cases these are CK-MB and ECHO.