Book contents
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Introduction
- Part 1 Perioperative Care of the Surgical Patient
- Section 1 General
- Section 2 Cardiology
- Chapter 9 Cardiovascular disease
- Chapter 10 Postoperative chest pain and shortness of breath
- Section 3 Hypertension
- Section 4 Pulmonary
- Section 5 Gastroenterology
- Section 6 Hematology
- Section 7 Infectious disease
- Section 8 Renal disease
- Section 9 Endocrinology
- Section 10 Rheumatology
- Section 11 Neurology
- Section 12 Surgery in the Elderly
- Section 13 Obesity
- Section 14 Transplantation
- Section 15 Psychiatric Disorders
- Section 16 Peripartum Patients
- Part 2 Surgical Procedures and their Complications
- Index
- References
Chapter 10 - Postoperative chest pain and shortness of breath
from Section 2 - Cardiology
Published online by Cambridge University Press: 05 September 2013
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Introduction
- Part 1 Perioperative Care of the Surgical Patient
- Section 1 General
- Section 2 Cardiology
- Chapter 9 Cardiovascular disease
- Chapter 10 Postoperative chest pain and shortness of breath
- Section 3 Hypertension
- Section 4 Pulmonary
- Section 5 Gastroenterology
- Section 6 Hematology
- Section 7 Infectious disease
- Section 8 Renal disease
- Section 9 Endocrinology
- Section 10 Rheumatology
- Section 11 Neurology
- Section 12 Surgery in the Elderly
- Section 13 Obesity
- Section 14 Transplantation
- Section 15 Psychiatric Disorders
- Section 16 Peripartum Patients
- Part 2 Surgical Procedures and their Complications
- Index
- References
Summary
Chest pain and shortness of breath are frequently encountered medical problems in the postoperative period. The differential diagnosis for these symptoms ranges from benign causes to medical emergencies necessitating immediate intervention. In order to accurately identify the etiology of these symptoms, the clinician must rely on a thorough history and physical examination in conjunction with the utilization of appropriate diagnostic tests. This chapter will review the differential diagnosis and evaluation of a patient with postoperative cardiopulmonary symptoms.
Evaluation and risk factor assessment
Potential pulmonary complications that may result in postoperative cardiopulmonary complaints include but are not limited to atelectasis, pneumonia, pleural effusion, pulmonary embolism (PE) and bronchospasm. These morbidities have been found to occur as frequently as cardiac complications in the postoperative period and have been identified as predictors of long-term mortality following surgery [1]. Risk factors for these complications are older age, emergency surgery, underlying chronic lung disease, poor nutritional status and advanced American Society of Anesthesiologists (ASA) class. Certain surgeries, such as those closest to the diaphragm as well as head and neck surgeries, incur a higher risk for postoperative pulmonary complications [1–4]. In addition, smoking appears to affect postoperative outcomes [5]. Table 10.1 includes a more comprehensive list of risk factors for pulmonary complications.
- Type
- Chapter
- Information
- Medical Management of the Surgical PatientA Textbook of Perioperative Medicine, pp. 113 - 118Publisher: Cambridge University PressPrint publication year: 2013