Background: Postoperative myocardial infarction (PMI) is a serious complication that could occur following any cardiac or noncardiac surgery. The likelihood of developing this complication is low in patients not fulfilling any of the revised cardiac risk index (RCRI) criteria. We report a case of PMI following elective noncardiac and nonvascular surgery in a patient not fulfilling any of the RCRI criteria.
Case Presentation: A 61-year-old male who had no chronic illnesses underwent elective endoscopic sinus surgery and septorhinoplasty. His preoperative assessment was unremarkable. Upon emergence from anesthesia, electrocardiogram changes were noted in the form of ST-elevations. This, along with the elevated troponin levels, indicated myocardial infarction (MI). The patient was treated with oxygen therapy, aspirin, nitroglycerin, morphine and then was shifted to the catheterization laboratory for coronary angiography and coronary artery catheterization.
Conclusion: PMI can occur in seemingly healthy patients undergoing low-risk surgeries. More studies need to be conducted to evaluate preoperative screening guidelines and tests to predict this devastating complication better. More studies should also be performed to assess the RCRIs criteria and accuracy in risk estimation.
Key words: Postoperative, myocardial infarction, noncardiac surgery, ischemic heart disease
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