myocardial infarction (fitness for anaesthesia)

Last reviewed 01/2018

The patient who has recently had a myocardial infarction is at increased risk of a fatal reinfarction during a general anaesthetic. The risk decreases with time until after three or possibly six months from the original event.

Therefore, it is prudent to postpone non-emergency general anaesthesia in a patient with a recent infarction for as long as possible. Six months is adequate for small, uncomplicated lesions in otherwise healthy patients.

Reinfarction, which may be silent, tends to occur early in the postoperative period and so continuous ECG monitoring is advisable during this period. The patient is often in the intensive care setting where serial ECG's and oxygen via a face mask are advantageous.