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July 1981

Anesthesia and the Patient With Heart Disease

Author Affiliations

New Haven, Conn

Arch Surg. 1981;116(7):973. doi:10.1001/archsurg.1981.01380190097029

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This 193-page book by 12 authors presents many important considerations for the patient with heart disease who must undergo general anesthesia. A brief synopsis of the basics of heart rate and rhythm, preload and afterload, and ventricular function is followed by a discussion of the effects of all modern anesthetic agents and adjuvants used in general anesthesia. Data from both animal and human studies are presented. The chapter on monitoring emphasizes the need for ECG monitoring of lead V5 in patients with ischemic heart disease. Monitoring the heart as a pump includes a short discussion of esophageal stethoscope, Doppler flowmeters, and, interestingly, a rather extensive discussion of central venous pressure. It is disappointing that pulmonary artery monitoring is mentioned only in passing. Techniques for external jugular cannulation and percutaneous radial artery cannulation are presented. Several studies that outline the risks of anesthesia in patients with previous myocardial infarction are

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