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J Arthroplasty. 2011 Apr;26(3):375-8. doi: 10.1016/j.arth.2010.02.009. Epub 2010 Apr 8.

Silent cardiac comorbidity in arthroplasty patients: an unusual suspect?

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Hiranandani Orthopaedic Medical Education, Department of Orthopaedics, Dr LH Hiranandani Hospital, Powai Mumbai, India.


We studied 109 patients who were subjected to dobutamine stress echocardiography (DSE) for preoperative cardiac risk assessment before undergoing elective primary hip and knee arthroplasty. Patients were selected for DSE based on several criteria. There were 16 patients with history of ischemic heart disease and 93 patients without. Seven of the 93 patients showed a positive DSE test result, of which 5 developed postoperative cardiac events (P = .00). This study clearly shows that serious "silent" cardiac comorbidity can exist even in so-called healthier patients undergoing routine hip and knee arthroplasty. We believe that identifying these patients and treating them before arthroplasty can significantly improve the overall outcome of the surgery.

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