Download – Heart Disease and Anaesthesia

Over the past six decades, mortality due solely to anaesthesia has decreased from approximately 1 in 1,500 to 1 in 150,000. However, death within 30 days of surgery remains a major issue. In the United Kingdom, over the past ten years, the number of such perioperative deaths has remained fairly constant at approximately 20,000 deaths per annum

 

, of which 9,000 are due to cardiac causes. For each cardiac death there are between 5 and 20 major cardiac complications, such as myocardial infarction, unstable angina, life-threatening arrhythmias, or acute left ventricular failure. Thus, the UK number of cardiac complications is expected to range from 45,000 to 180,000 per annum. These complications occur in patients with a compromised cardiovascular system, most frequently because of underlying coronary artery disease. Indeed, 60% of patients who die within 30 days of surgery have evidence of coronary heart disease. Pre-existing valvular heart disease, hypertensive heart disease, and congestive cardiac failure also play an important role.

Pierre Foex