Book contents
- Frontmatter
- Contents
- Preface
- Preface to the 1st edition
- Abbreviations
- 1 Advice on answering short answer questions
- 2 General Anaesthesia
- 3 Anaesthesia and Medical Disease
- 4 Medicine and Intensive Care
- 5 Obstetric Anaesthesia and Analgesia
- 6 Paediatric Anaesthesia
- 7 Neuroanaesthesia
- 8 Acute and Chronic Pain
- 9 Trauma and Emergency Anaesthesia
- 10 Anatomy, Applied Anatomy and Regional Anaesthesia
- 11 Pharmacology and Applied Pharmacology
- 12 Clinical Measurement and Equipment
- 13 Cardiac and Thoracic Anaesthesia
- Index
3 - Anaesthesia and Medical Disease
Published online by Cambridge University Press: 05 February 2014
- Frontmatter
- Contents
- Preface
- Preface to the 1st edition
- Abbreviations
- 1 Advice on answering short answer questions
- 2 General Anaesthesia
- 3 Anaesthesia and Medical Disease
- 4 Medicine and Intensive Care
- 5 Obstetric Anaesthesia and Analgesia
- 6 Paediatric Anaesthesia
- 7 Neuroanaesthesia
- 8 Acute and Chronic Pain
- 9 Trauma and Emergency Anaesthesia
- 10 Anatomy, Applied Anatomy and Regional Anaesthesia
- 11 Pharmacology and Applied Pharmacology
- 12 Clinical Measurement and Equipment
- 13 Cardiac and Thoracic Anaesthesia
- Index
Summary
A patient who has undergone heart transplantation requires non-cardiac surgery. What problems may this present for the anaesthetist?
Heart transplantation is well established and it is increasingly common for patients to present for non-cardiac surgery. The difficulties that such patients present are in fact quite modest, but it is important for anaesthetists to appreciate the physiological implications.
Introduction
Long-term survival after cardiac transplantation is continuing to improve and it is increasingly frequent for patients to present for non-cardiac surgery. Anaesthetic problems are related to the natural history of the transplanted heart, to its altered physiology and to the effects of the necessary immunosuppressive drug regimens.
Natural history of the transplanted heart
Heart transplantation is a treatment for end-stage cardiac disease
— In some patients, for example those with hyperlipidaemias, the underlying diathesis persists and may continue to affect coronary artery patency.
— Graft atherosclerosis may also be accelerated by the chronic rejection process and so patients must be assumed to have coronary artery disease.
— Transplanted hearts are denervated and so patients do not usually suffer from warning signs of angina pectoris (some believe that residual reinnervation can eventually occur).
- Type
- Chapter
- Information
- Short Answer Questions in Anaesthesia , pp. 99 - 130Publisher: Cambridge University PressPrint publication year: 2002