Why dies-on of a cardiac arrest after an operation that does not relate to the heart ?
Published the 07.12.2017 at 07: 15
chirurgieinfarctus of the myocardemortalité peri-operative
A new study published by the American Heart Association in the journal Circulation shows how an operation which is not related to the heart can cause a myocardial infarction, a leading cause of death.
Known under the term ” infarct peri-operative “, it is a complication which still remained a mystery to science. It mainly affects people who have a high risk of developing heart disease, including by their age. These lesions are, however, associated with mortality, often within thirty days after the surgical intervention.
Of lesions not detected
These are lesions that affect the heart cells that lead to necrosis of the muscular wall of the heart or myocardial infarction. The issue is that this complication is to this day still undetectable by doctors. In fact, the patients do not show particular signs after their operation. No pain in the chest for example, then it is the symptom the most typical of myocardial infarction.
The interventions that are relevant will vary from operation to be low risk, as any procedure on the prostate or a knee prosthesis operations at risk average heart as cholecystectomy, or the implementation of a total prosthesis of the hip, up to higher-risk operations as a by-pass of arteries of the legs or the removal of a lung and the liver.
Troponin, an indicator
From 2014 to 2015, 2018 patients with a high risk of developing heart disease were included in the study. They have suffered, in all, 2546 surgery non-cardiac.
The researchers measured their level of troponin in the blood, before and after the operation. Troponin is a protein of cardiac origin, which can indicate if the heart is damaged, even without symptoms. The more it is elevated, the more damage.
According to the study, some patients have a higher risk of suffering a myocardial peri-operative. People over 65 years of age for example, or those who have already suffered a coronary heart disease, arterial disease of the lower limbs or of a judgment of a cardio-vascular of which 1 in 7 has had a myocardial infarction.
Recognize infarction as a leading cause of perioperative mortality will improve the prognosis of the surgery in the person at risk, even if there is still no clear treatment for this complication.
According to Christian Puelacher, first author of the study and a clinical researcher at the Institute of cardiovascular research, Basel, Switzerland, these future treatments will need to be individualized for each patient.