perioperative myocardial infarction
Heart attack occurring during or within 48 hours of cardiac surgery, often related to inadequate myocardial protection.
Full Definition
Perioperative myocardial infarction (PMI) is a serious complication of cardiac surgery that occurs during the operative period or within 48 hours postoperatively. It results from inadequate myocardial protection, coronary embolization, graft failure, or incomplete revascularization. PMI is typically diagnosed by elevated cardiac enzymes (troponin, CK-MB) in combination with ECG changes or new wall motion abnormalities on echocardiography. The condition significantly increases morbidity and mortality and may necessitate emergency revascularization or mechanical circulatory support. Prevention strategies include optimal myocardial protection techniques, complete revascularization, and careful operative technique to avoid coronary air embolism.
Usage
Usage note: PMI is acceptable abbreviation in cardiac surgical contexts
In Context
- "The patient developed perioperative myocardial infarction with peak troponin levels exceeding 50 ng/mL." — complication report
- "Strategies to prevent perioperative myocardial infarction include optimal cardioplegia delivery and de-airing techniques." — surgical protocol