Perioperative management of patients affected by ischemic cardiomyopathy

The incidence of myocardial infarction after surgery is relatively high. In a recent multicenter study, 3904 out of 21,842 patients over 45 years of age (18%) presented the diagnostic criteria for myocardial injury of ischemic origin in the first three postoperative days after noncardiac surgery [1]. This complication was particularly insidious because it is associated with a 30-day mortality of 4.1%, against 0.6% in the remaining patients, and because the characteristic symptoms of myocardial ischemia were absent in over 90% of cases.