What are
the common intraoperative monitors for myocardial ischemia?
The most common monitor of intraoperative
ischemia is electrocardiography. At least two leads should be moni-tored in
order to diagnose more than 95% of ischemic episodes. The pulmonary artery
catheter can also be used to diagnose ischemia when the PCWP or the pulmonary
artery diastolic pressure increases. This can also be referred to as a “v wave”
of the PCWP tracing. The PCWP is not as sensitive as the electrocardiogram for
detecting ischemia. The most sensitive monitor for ischemia is TEE, in which
regional wall motion abnormalities occur very early in the course of reduced
coronary perfusion. TEE is probably too sensitive; PCWP is probably not
sensitive enough; thereby leaving electrocardiography as the most accurate
monitor of coronary ischemia.
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