{"id":2477,"date":"2009-07-21T12:10:38","date_gmt":"2009-07-21T12:10:38","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/carens\/"},"modified":"2025-05-14T19:09:21","modified_gmt":"2025-05-14T19:09:21","slug":"carens","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/es\/carens\/","title":{"rendered":"Evaluaci\u00f3n Cardiovascular Perioperatoria para Cirug\u00eda No Cardiaca"},"content":{"rendered":"<div class=\"7ca9444b8380138fe077da07353677a4\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p><strong>Predictores Cl\u00ednicos de Riesgo Cardiovascular Perioperatorio Aumentado (Infarto de Miocardio, insuficiencia card\u00edaca, Muerte)<\/strong><\/p>\n<p><strong>Mayor<\/strong><\/p>\n<ul>\n<li>S\u00edndromes coronarios inestables\n<ul style=\"list-style-type: circle;\">\n<li>Infarto de miocardio agudo o reciente* con evidencia de riesgo isqu\u00e9mico importante por s\u00edntomas cl\u00ednicos o estudios no invasivos<\/li>\n<li>Angina inestable o severa\u2020 (clase Canad\u00e1 III o IV)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><!--more--><\/p>\n<ul>\n<li>Insuficiencia cardiaca descompensada<\/li>\n<li>Arritmias significativas\n<ul style=\"list-style-type: circle;\">\n<li>Bloqueo auriculoventricular de alto grado<\/li>\n<li>Arritmias ventriculares sintom\u00e1ticas en presencia de enfermedad cardiaca subyacente<\/li>\n<li>Arritmias supraventriculares con frecuencia ventricular descontrolada<\/li>\n<\/ul>\n<\/li>\n<li>Enfermedad valvular severa<\/li>\n<\/ul>\n<p><strong>Intermedio<\/strong><\/p>\n<ul>\n<li>Angina de pecho leve (clase Canad\u00e1 I o II)<\/li>\n<li>Infarto de miocardio previo por historia u ondas Q patol\u00f3gicas<\/li>\n<li>Insuficiencia cardiaca previa o compensada<\/li>\n<li>Diabetes mellitus (en particular, insulino-dependiente)<\/li>\n<li>Insuficiencia renal<\/li>\n<\/ul>\n<p><strong>Menor<\/strong><\/p>\n<ul>\n<li>Edad avanzada<\/li>\n<li>ECG anormal (hipertrofia ventricular izquierda, bloqueo de rama izquierda, alteraciones ST-T)<\/li>\n<li>Ritmo diferente al sinusal (por ejemplo, fibrilaci\u00f3n auricular)<\/li>\n<li>Baja capacidad funcional (por ejemplo, la incapacidad para subir una escalera con una bolsa de comestibles)<\/li>\n<li>Antecedente de accidente cerebrovascular<\/li>\n<li>Hipertensi\u00f3n arterial sist\u00e9mica no controlada<\/li>\n<\/ul>\n<p>ECG indica electrocardiograma; IM, infarto de miocardio.<br \/>\n* El American College of Cardiology define MI reciente como superior a 7 d\u00edas, pero inferior o igual a 1 mes (30 d\u00edas); MI agudo se encuentra dentro de 7 d\u00edas.<br \/>\n\u2020 Puede incluir angina \u00abestable\u00bb en pacientes que son inusualmente sedentarios.<\/p>\n<p><strong>Estratificaci\u00f3n de Riesgo Cardiaco* para Procedimientos Quir\u00fargicos No Cardiacos<\/strong><\/p>\n<p><strong>Alto<\/strong>\u00a0(Riesgo card\u00edaco reportado superior a 5%)<\/p>\n<ul>\n<li>Cirug\u00edas mayores, en particular en los ancianos<\/li>\n<li>Cirug\u00eda vascular de aorta y otros grandes vasos<\/li>\n<li>Cirug\u00eda vascular perif\u00e9rica<\/li>\n<li>Procedimientos quir\u00fargicos prolongados programados asociados con grandes cambios de fluidos y\/o p\u00e9rdida de sangre<\/li>\n<\/ul>\n<p><strong>Intermedio\u00a0<\/strong>(Riesgo card\u00edaco reportado, menos del 5%)<\/p>\n<ul>\n<li>Endarterectom\u00eda carot\u00eddea<\/li>\n<li>Cirug\u00eda de cabeza y cuello<\/li>\n<li>Cirug\u00eda intraperitoneal e intrator\u00e1cica<\/li>\n<li>Cirug\u00eda ortop\u00e9dica<\/li>\n<li>Cirug\u00eda de pr\u00f3stata<\/li>\n<\/ul>\n<p><strong>Baja\u2020<\/strong>\u00a0(Riesgo card\u00edaco reportado, menos del 1%)<\/p>\n<ul>\n<li>Procedimientos endosc\u00f3picos<\/li>\n<li>Procedimiento superficial<\/li>\n<li>Cirug\u00eda de catarata<\/li>\n<li>Cirug\u00eda de mama<\/li>\n<\/ul>\n<p>* Incidencia combinada de muerte card\u00edaca e infarto de miocardio no fatal.<br \/>\n\u2020 Generalmente no requieren pruebas card\u00edacas preoperatorias adicionales.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Bibliograf\u00eda:<\/strong><\/p>\n<ol>\n<li>Fleisher LA, Beckman JA, Brown KA, Calkins H, Chaikof E, Fleischmann KE, Freeman WK, Froehlich JB, Kasper EK, Kersten JR, Riegel B, Robb JF, Smith SC Jr, Jacobs K, Adams CD, Anderson JL, Antman EM, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Hunt SA, Lytle BW, Nishimura R, Page RL, Riegel B; American College of Cardiology\/American Heart Association Task Force on Practice Guidelines Writing Committee to Update the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery; American Society of Echocardiography; American Society of Nuclear Cardiology; Heart Rhythm Society; Society of Cardiovascular Anesthesiologists; Society for Cardiovascular Angiography and Interventions; Society for Vascular Medicine and Biology. ACC\/AHA 2006 guideline update on perioperative cardiovascular evaluation for noncardiac surgery: focused update on perioperative beta-blocker therapy: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery): developed in collaboration with the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society for Vascular Medicine and Biology. Circulation. 2006 Jun 6;113(22):2662-74.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/16754815\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Eagle KA, Berger PB, Calkins H, Chaitman BR, Ewy GA, Fleischmann KE, Fleisher LA, Froehlich JB, Gusberg RJ, Leppo JA, Ryan T, Schlant RC, Winters WL Jr, Gibbons RJ, Antman EM, Alpert JS, Faxon DP, Fuster V, Gregoratos G, Jacobs AK, Hiratzka LF, Russell RO, Smith SC Jr; American College of Cardiology\/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1996 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery). ACC\/AHA guideline update for perioperative cardiovascular evaluation for noncardiac surgery&#8212;executive summary a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1996 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery). Circulation. 2002 Mar 12;105(10):1257-67.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/11889023\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Creado: Jul 21, 2009<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Predictores Cl\u00ednicos de Riesgo Cardiovascular Perioperatorio Aumentado (Infarto de Miocardio, insuficiencia card\u00edaca, Muerte) Mayor S\u00edndromes coronarios inestables Infarto de miocardio agudo o reciente* con evidencia de riesgo isqu\u00e9mico importante por s\u00edntomas cl\u00ednicos o estudios no invasivos Angina inestable o severa\u2020 (clase Canad\u00e1 III o IV)<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[26],"tags":[1348,847,770,161,160,1447,1446,1445,766],"class_list":["post-2477","post","type-post","status-publish","format-standard","hentry","category-cardiology","tag-cardiology","tag-cardiovascular","tag-cirugia","tag-evaluacion","tag-evaluation","tag-noncardiac","tag-perioperative","tag-perioperatorio","tag-surgery"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/2477","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/comments?post=2477"}],"version-history":[{"count":3,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/2477\/revisions"}],"predecessor-version":[{"id":9159,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/2477\/revisions\/9159"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/media?parent=2477"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/categories?post=2477"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/tags?post=2477"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}