Myocardial ischemia
Myocardial ischemia is caused by a lack of oxygen-rich blood to the heart muscle. If the ischemia is allowed to persist for a prolonged period of time, the effect will be permanent myocardial infarction. Myocardial ischemia and subsequent myocardial infarction is a common complication after cardiac surgery, and is closely associated with increased morbidity and mortality.
In patients not subjected to cardiac surgery, the diagnosis of myocardial ischemia is well established and based on clinical symptoms of ischemia, ischemia associated ECG changes and elevated cardiac biomarkers. In cardiac surgery patients, the surgical trauma itself causes myocardial damage, which makes the diagnosis of myocardial ischemia much more difficult, and today there is no accepted gold standard for diagnosis of post-operative myocardial ischemia.
