心血管系併発病態に対する術前評価

Preoperative Evaluation of Cardiovascular Complications in Elderly Patients Undergoing Urgent Surgery

はじめに

　近年の麻酔の大きな特徴の一つは，高齢者の割合が増加していることである。6-24時間以内に手術が必要な準緊急手術を必要とする高齢者において，限られた時間内で，高齢者に頻発しうる心血管系併発病態の評価をどのように行うかについて本論文で概説する。

　One of the major characteristics of anesthesia in recent years has been the increasing proportion of elderly patients.

　In the elderly who require quasi-emergency surgery requiring surgery within 6-24 hours, it is necessary to assess cardiovascular complications that may frequently occur in the elderly in a limited time.

　Before urgent surgery in elderly patients, the presence of a heart murmur, chest pain, dyspnea, and peripheral edema should be confirmed by medical history and physical examination.

　Then, a preoperative risk assessment should be performed, including an evaluation of exercise tolerance and an assessment of the presence of cardiovascular risk factors.

　If clinical findings suggest cardiovascular disease or a high risk of perioperative cardiac complications, an electrocardiogram, biomarker measurements, and transthoracic echocardiography are recommended.