Many reports have appeared stressing the frequency of the association of surgical procedures and acute myocardial infarction in poor-risk patients, especially those more than 50 years of age.* The fall in blood pressure which often accompanies, or follows, the administration of an anesthetic and the performance of surgery has been considered a significant factor in the reduction of blood flow to the myocardium and the occurrence of coronary arterial thrombosis.† Anemia may be an added factor in decreasing the amount of oxygen available to the heart. Coronary arterial sclerosis with narrowing of the arterial lumina, often unsuspected, is of obvious primary importance, for pathologic observations have revealed that severe coronary arteriosclerosis is almost always present in patients with myocardial infarction discovered postoperatively.8 The clinical diagnosis of myocardial infarction can be difficult,3 especially if it occurs during anesthesia or in the immediate postoperative period when the patient's sensorium
LEE KT, O'NEAL RM. Myocardial Infarction Associated with Surgical Operation. AMA Arch Surg. 1956;72(4):622–627. doi:https://doi.org/10.1001/archsurg.1956.01270220070009
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