Postoperative Coronary Thrombosis and Myocardial Infarction

¹ Medical Service, Veterans Administration Hospital, Coral Gables, Florida.

The frequency of postoperative myocardial infarction or coronary thrombosis at the Coral Gables Veterans Administration Hospital in patients with recognized arteriosclerotic heart disease was 3 per cent. A review of the operative and postoperative courses of these patients demonstrates a frequent association of protracted states of coronary insufficiency and the occurrences of subsequent cardiac insults. Anemias at the time of surgery, operative tachycardia and shock, and noncardiac complications were productive of coronary insufficiency by interference with oxygenation of blood, decreasing coronary blood flow and increasing cardiac work.

The most important tool available in recognizing an underlying coronary insufficiency is a detailed cardiac history. An electrocardiogram serves as an invaluable supplement by providing evidence of remote myocardial infarction and recent coronary insufficiency. Recognition of arteriosclerotic heart disease will necessitate a coordinated effort directed towards prevention, and prompt correction, of coronary insufficiency in the preoperative, operative and postoperative periods.