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Review
. 2001 Dec;19(4):651-72.

Myocardial ischemia. Monitoring to diagnose ischemia: how do I monitor therapy?

Affiliations
  • PMID: 11778376
Review

Myocardial ischemia. Monitoring to diagnose ischemia: how do I monitor therapy?

K L Skidmore et al. Anesthesiol Clin North Am. 2001 Dec.

Abstract

Diagnosis of myocardial ischemia requires integration of ECG, pulmonary artery pressures, and TEE data. ST depression of 1 mV or elevation of 2 mV remains the mainstay of diagnosis of ischemia. Increases of pulmonary artery pressures of 5 mm Hg are common but not reliably diagnostic of ischemia. Transesophageal echocardiography is the most sensitive monitor of ischemia, where the spectra of SWMA evolve. Diastolic dysfunction (elevations in LVEDP) is a more sensitive marker of ischemia, but requires measurement of several Doppler patterns. After diagnosis, treatment should include optimization of hemodynamics (beginning with beta-blockers and nitrates), anesthesia, and oxygen-carrying capacity (e.g., normothermia, oxygen saturation, hematocrit more than 28%).

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