Noncardiac surgery in the patient with heart disease.
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Biomedical subjects
Publications and source records attributed to K B Keller.
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Advancing age is associated with significantly greater mortality and morbidity in the elderly undergoing coronary artery bypass grafting or PTCA. Nevertheless, successful bypass surgery or PTCA in the elderly has significant benefits (i.e., relief of angina or increase in longevity) that exceed that of the United States population matched for age and gender. Continued improvement in skills in cardiac surgery and PTCA correlated significantly with a progressively better prognosis in the young as well as the elderly.
CAD in young male adults below the age of 40 years has generally been found to be associated with the usual risk factors associated with CAD. In a lesser number of young adults, MIs may be related to cocaine use. Sympathomimetic effects and increase in myocardial oxygen demand are factors considered responsible for acute MI in cocaine-abusing patients. In young adults who are asymptomatic following an acute MI and who are able to pass treadmill exercise stress tests at levels of Bruce stage 4 have been shown to have normal coronary arteriograms. Thus this subset should not require routine coronary angiograms following an acute MI.
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