Detection of Preoperative Cardiac Abnormalities in Asymptomatic Patients Undergoing Low to Intermediate Risk Non-Cardiac Surgery

Abstract

Background: In patients having non-cardiac surgery, perioperative cardiovascular problems constitute the primary contributor to both morbidity and death.

Objective: Uncovering hidden cardiac problems among asymptomatic patients that may cause complications  during and after low to intermediate risk non-cardiac surgery.

Subjects and Methods: The study was conducted on 300 cases; and all of  them were subjected to full preoperative cardiac assessment including full history taking, clinical examination, laboratory investigations,  12-lead surface ECG and transthoracic echocardiography to exclude any case with significant heart disease. All patients were followed up during hospital stay for assessment of perioperative complications.

Results: Regarding incidence of complications and types of cardiac  complications distribution among study groups, 275 patients (91.7%) had no complications and 25 patients (8.3%) had complications in  the form of: sinus tachycardia (5 patients “1.7%”), hypotension (4 patients “1.3%”), Supra ventricular tachycardia (4 patients “1.3%”),  arrested (3 patients “1.0%”), venous thrombosis (3 patients “1.0%”), Atrial fibrillation (2 patients “0.7%”), pulmonary embolism (2 patients “0.7%”), acute pulmonary edema (one patient “0.3%”) and suspected pulmonary embolism (one patient “0.3%”).

Conclusion: There was  a statistically significant increase in postoperative complications among cardiac patients who did not exhibit any symptoms. The clinical  and predictive use of routine preoperative electrocardiography (ECG) and echocardiography (ECHO) in persons having low- to  intermediate-risk surgery for major cardiac adverse events is limited.