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Peri operative Myocardial Infarction : Peri operative Myocardial Infarction is diagnosed by the appearance of fresh Q waves. Non-Q, myocardial infarction is suspected when there is serial rise in cardiac enzymes. Initial reading of cardiac enzymes after CAHG on by pass, may show elevation, which settles down if there is no peri operative MI. With better myocardial protection these days, the incidence of peri operative MI which was 5.8 per cent in CASS report has come down Lo 2.5 per cent or even less. The incidence is higher after endarterectomy. In recent reports, there is no difference in the incidence of pemi operative MI between CABG on pump and off pump (OPCAB).
Late follow up shows that 95 per cent of the patients are free of fatal or nonfatal MI five years after CABG. This falls to 85 per cent at 10 years and 65 per cent at 15 years.
System of classification The Enzyme Commission divided enzymes into 6 main classes, on the basis of the total reaction catalyzed. Each enzyme was assigned a code number; consis
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