Abstract
Perioperative myocardial ischaemia and myocardial infarction have become a growing problem bringing an increase in mortality, hospital length of stay and financial costs. The incidence is higher postoperatively than in the immediate preoperative and perioperative period.
There are two distinct patho-physiological mechanisms which may lead to perioperative myocardial infarction: myocardial injury related to the rupture, fissuring, erosion or dissection of an atherosclerotic plaque (myocardial infarction type 1) and prolonged imbalance in myocardial oxygen supply and demand (myocardial infarction type 2). The review article discusses the diagnostics (ECG, cardiac biomarkers, intraoperative ECHO), prevention (the question of preoperative myocardial revascularization) and management according to guidelines reflecting Evidence Based Medicine.