Prevention and Management of Cardiac Dysfunction during and after Cardiac Surgery.

Surgery is analogous to an extreme stress test. It initiates inflammatory, hypercoagulable, stress, and hypoxic states, which may be associated with elevations in troponin levels leading to postoperative myocardial dysfunction and failure [1]. Cardiac surgery, especially, is associated with the inherent risk of myocardial ischemia and myocardial infarction; and consequently, with postoperative heart failure. The degree of permanent postoperative myocardial injury is determined by the severity and duration of ischemia. A progressive pattern of myocardial dysfunction-apart from ongoing ischemia-suggests that additional underlying mechanisms, which are at least partially different from those of myocardial stunning, may also exist [2]. [ABSTRACT FROM AUTHOR]