CAD & Risks of Non Cardiac Surgery

Plaque build-up in coronary arteries is the cause of CAD (coronary artery disease). Too much blockage can keep oxygenated blood from flowing to the heart, causing the heart to overwork to a point that it suffers injury and becomes insufficient in its job, leading to death. Stress factors that can complicate the health of a patient who has CAD are excessive weight gain, diabetes, smoking, excess alcohol consumption, high cholesterol and high blood pressure. In addition, surgery and anesthesia can put a CAD patient at risk, requiring pre-surgical precautions.

Risks

• Surgery can place unusual stress on the heart when a patient is anxious over the procedure. General anesthesia can put stress on the heart, but spinals and epidurals can reduce the risks. These alternatives are very affective during hip and knee surgeries, which are common among the elderly.

  Some medications may need to be discontinued before surgery, such as anti-coagulants, which may raise the risk blood clotting.

  Respiratory diseases such as asthma and emphysema can put stress on the heart, complicating recovery. Dementia also can be a risk factor because the patient cannot participate in his care and may cause undue harm to himself.

Preoperative Medication Treatment

• Medications used preoperative can include B blockade, heparin, calcium antagonists, aspirin, nitrates and potassium channel activators. According to a June 1, 2010, article in Physician's Weekly, the B blockers have been known to reduce silent myocardial ischemia (constriction of the artery). The B blockade is administered preoperative and sometimes peri-operative. Careful evaluation of the patient takes place to ensure that bradycardia (slow heart rate) and hypotension (low blood pressure) do not occur. B blockade prevents a boost in substances such as adrenaline, which can stress the heart. Often used in blood pressure therapy, B blockade is the treatment of choice for preoperative CAD patients.

Postoperative Risks

• Depending on the type of surgery, recovery can be long and strenuous. Patients with CAD may take longer to heal, especially if their condition is complicated with diabetes. Movement after surgery is essential to avoid blood clotting in the legs but it can be just as important for the heart.

  Other post-operative risks that can affect the heart include bleeding, medications, falling injuries, breathing conditions and infections.

  Patients who received stents for treatment of recent heart attacks showed a greater risk after non-cardiac surgery. According to the American Heart Association, heart attacks occurred in 65 percent of such patients. Postponing non-cardiac surgery for six weeks can reduce risks of heart attack. Patients with chronic disease who did not receive stents before non-cardiac surgery experienced heart attacks at the rate of 32 percent.