Die weite Verbreitung kardiovaskulärer Erkrankungen, höhere Lebenserwartung und Zunahme immer komplexerer operativer Eingriffe bei alten und/ oder multimorbiden Patienten konfrontieren den Anästhesisten mit der Forderung, diesen Gegebenheiten im perioperativen anästhesiologischen Management Rechnung zu tragen. Die kardiale Morbidität ist trotz aller Fortschritte der operativen Medizin führende Todesursache nach Narkose und Operation. Neuere Arbeiten über kardiovaskuläre Risikopatienten und stille Myokardischämien modifizieren unsere traditionelle Vorstellung über die koronare Herzkrankheit dahingehend, nicht nur den symptomatischen Patienten, sondern auch den asymptomatisch, anhand klar formulierter Kriterien definierten Patienten mit Risikofaktoren in das Kollektiv koronarer Problempatienten einzufügen.


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