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Cardiology160 papers

Postoperative acute myocardial infarction

Last edited: 4/13/2026

Overview

Postoperative acute myocardial infarction (AMI) refers to myocardial infarction occurring after a surgical procedure, often highlighting the need for vigilant cardiac monitoring and management in postoperative settings to mitigate complications 2024.

Diagnosis

  • Clinical presentation includes chest pain, ECG changes, and elevated cardiac biomarkers 20.
  • Imaging studies such as echocardiography and coronary angiography may be necessary to assess coronary artery patency and ventricular function 2021.
  • Troponin levels are crucial for confirming myocardial injury 20.

    • Management

  • Reperfusion Therapy: Primary PCI or thrombolysis if PCI is not immediately available (Evidence: Strong 20).
  • Antiplatelet Therapy: Initiation of aspirin and P2Y12 inhibitor (e.g., clopidogrel, ticagrelor) (Evidence: Strong 20).
  • Anticoagulation: Use of anticoagulants like heparin or bivalirudin to prevent clot propagation (Evidence: Strong 20).
  • Management of Comorbidities: Addressing hypertension, diabetes, and hyperlipidemia to reduce cardiovascular risk (Evidence: Moderate 20).
  • Supportive Care: Including hemodynamic support and management of heart failure symptoms (Evidence: Moderate 20).

    • Special Populations

  • Pregnancy: Special considerations for radiation exposure and use of teratogenic drugs; consult radiation protection guidelines for pregnant healthcare workers (Evidence: Expert opinion 14).
  • Pediatrics: Lower threshold for intervention due to vulnerability; careful monitoring of radiation doses during procedures (Evidence: Moderate 2829).
  • Elderly: Tailored management considering comorbidities and frailty; cautious use of aggressive reperfusion strategies (Evidence: Moderate 20).
  • Comorbidities: Specific management adjustments based on coexisting conditions like renal impairment or bleeding risk (Evidence: Moderate 20).

    • Key Recommendations

  • Implement Early Reperfusion Therapy: Initiate primary PCI or thrombolysis promptly to restore coronary flow (Evidence: Strong 20).
  • Optimize Antithrombotic Therapy: Use dual antiplatelet therapy and appropriate anticoagulation to prevent further clot formation (Evidence: Strong 20).
  • Monitor Radiation Exposure: Employ personal dosimeters and protective measures to minimize occupational radiation exposure for staff (Evidence: Moderate 1715).
  • Tailor Management to Patient-Specific Factors: Adjust treatment plans considering age, comorbidities, and pregnancy status to minimize risks (Evidence: Moderate 2014).
  • Enhance Radiation Protection Practices: Adopt state-of-the-art equipment and protocols to protect both patients and staff from unnecessary radiation exposure (Evidence: Moderate 2020).

    • References

    1 Giordano C, Vitali S, Garioni M, Camatti J, Terulla A, Marini P et al.. Conversion factors between whole-body and organ doses in interventional cardiology: an italian multicentre study. Biomedical physics & engineering express 2026. link 2 Alexandrou M, Alexandrou D, Kearney KE, Guerrero M, Karacsonyi J, Hall AB et al.. From Representation to Reform: A Qualitative Study of Gender Equity in Interventional Cardiology. The American journal of cardiology 2026. link 3 Dhatt A, de Korompay N, Heran MKS, Chang MR, Ho S, Liu DM et al.. Understanding the Canadian Interventional Radiology Landscape Through the Canadian Association of Interventional Radiology Database: A Descriptive Study. Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes 2026. link 4 Çetinarslan Ö, Acar Ş, Sönmez IY, Zoghi M. Women's Representation in Interventional Cardiology and Other Interventional Fields: Opportunities and Challenges. Anatolian journal of cardiology 2025. link 5 Hışıroğlu KA, Toker O, Özşahin MT, İçelli O. Machine learning-based estimation of occupational radiation dose in interventional cardiology. Radiation protection dosimetry 2025. link 6 Costa H, Vinhas H, Calé R, Pereira E, Santos J, Paulo G et al.. A report on a survey among Portuguese Association of Interventional Cardiology associates regarding ionizing radiation protection practices in national interventional cath-labs. Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology 2024. link 7 Wickramasinghe SU, Ramanathan V, Sarasanandarajah S, De Zoyza M, Paranamana R. Occupational dose measurement in interventional cardiology practice. Radiation protection dosimetry 2024. link 8 Kostova-Lefterova D, Mateev H, Aleksandrov A, Ivanova E, Vladimirov G, Bankova A et al.. A 17-Years Follow-up of Occupational Radiation Doses in an Interventional Cardiology Department. Current medical imaging 2024. link 9 Udara Wickramasinghe S, Ramanathan V, Sarasanandarajah S. Assessment of occupational eye lens dose in interventional cardiology suites in Sri Lanka. Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB) 2024. link 10 Bharadwaj AS, Cader FA, Goldsweig AM, Kini A, Sharma S, Gluckman TJ et al.. Emerging Educational and Networking Platforms in Interventional Cardiology: Expanding Beyond Traditional Social Media. Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions 2024. link 11 Vano E, Fernández-Soto JM, Sánchez-Casanueva RM, Ten Morón JI. Improving a regional project on diagnostic reference levels for interventional procedures (OPRIPALC) with the support of a dose management system for the protection of patients and staff. Journal of radiological protection : official journal of the Society for Radiological Protection 2024. link 12 Feghali JA, Delépierre J, Belac OC, Dabin J, Deleu M, De Monte F et al.. Establishing a priori and a posteriori predictive models to assess patients' peak skin dose in interventional cardiology. Part 2: results of the VERIDIC project. Acta radiologica (Stockholm, Sweden : 1987) 2023. link 13 El Hassane C, Ali AB, Bendaoud N, Boushaki GMI. Radiation exposure in interventional cardiology: extremities doses. Radiation protection dosimetry 2023. link 14 Manzo-Silberman S, Velázquez M, Burgess S, Sahni S, Best P, Mehran R et al.. Radiation protection for healthcare professionals working in catheterisation laboratories during pregnancy: a statement of the European Association of Percutaneous Cardiovascular Interventions (EAPCI) in collaboration with the European Heart Rhythm Association (EHRA), the European Association of Cardiovascular Imaging (EACVI), the ESC Regulatory Affairs Committee and Women as One. EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology 2023. link 15 Buchanan GL, Paradies V, Karam N, Holmvang L, Mamas MA, Mehilli J et al.. Overcoming professional barriers encountered by women in interventional cardiology: an EAPCI statement. European heart journal 2023. link 16 Ferrari P, Becker F, Campani L, Jansen J, Jovanović Z, Krstić D et al.. ON THE PLACEMENT OF APRON DOSEMETERS AND DOSE ASSESSMENT IN INTERVENTIONAL CARDIOLOGY PROCEDURES: PRELIMINARY RESULTS. Radiation protection dosimetry 2022. link 17 Ishii H, Chida K, Satsurai K, Haga Y, Kaga Y, Abe M et al.. Occupational eye dose correlation with neck dose and patient-related quantities in interventional cardiology procedures. Radiological physics and technology 2022. link 18 O'Connor U, Walsh C, Gorman D, O'Reilly G, Martin Z, Madhavan P et al.. Feasibility study of computational occupational dosimetry: evaluating a proof-of-concept in an endovascular and interventional cardiology setting. Journal of radiological protection : official journal of the Society for Radiological Protection 2022. link 19 Weaver JJ, Shin DS, Chick JFB, Monroe EJ. Intravascular ultrasound for endovascular precision in pediatrics. Pediatric radiology 2022. link 20 Behr-Meenen C, von Boetticher H, Kersten JF, Nienhaus A. Radiation Protection in Interventional Radiology/Cardiology-Is State-of-the-Art Equipment Used?. International journal of environmental research and public health 2021. link 21 Krajinović M, Kržanović N, Ciraj-Bjelac O. Vendor-independent skin dose mapping application for interventional radiology and cardiology. Journal of applied clinical medical physics 2021. link 22 Goldsweig AM, Galper BZ, Alraies C, Arnold SV, Daniels M, Capodanno D et al.. #SoMe for #IC: Optimal use of social media in interventional cardiology. Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions 2021. link 23 Krajinović M, Dobrić M, Ciraj-Bjelac O. SKIN DOSE MAPPING IN INTERVENTIONAL CARDIOLOGY: A PRACTICAL SOLUTION. Radiation protection dosimetry 2020. link 24 Tefera E, Qureshi SA, Gezmu AM, Mazhani L. Radiation protection knowledge and practices in interventional cardiologists practicing in Africa: a cross sectional survey. Journal of radiological protection : official journal of the Society for Radiological Protection 2020. link 25 Domienik-Andrzejewska J, Brodecki M, Zmyślony M. CORRELATION OF EYE LENS DOSES AND PERSONAL DOSE EQUIVALENT MEASURED ON THE ARM OF INTERVENTIONAL CARDIOLOGISTS FOR A RETROSPECTIVE ASSESSMENT OF DOSES TO OPERATORS' EYE LENS. Radiation protection dosimetry 2020. link 26 Morrison J, Plomondon ME, O'Donnell CI, Giri J, Doll JA, Valle JA et al.. Perceptions of Public and Nonpublic Reporting of Interventional Cardiology Outcomes and Its Impact on Practice: Insights From the Veterans Affairs Clinical Assessment, Reporting, and Tracking Program. Journal of the American Heart Association 2019. link 27 Ubeda C, Morales C, Gutiérrez D, Oliveira M, Manterola C. OCCUPATIONAL DOSE DURING ADULT INTERVENTIONAL CARDIOLOGY: FIRST VALUES WITH PERSONAL ACTIVE DOSIMETERS IN CHILE. Radiation protection dosimetry 2018. link 28 Ubeda C, Miranda P, Aguirre D, Riquelme N, Dalmazzo D, Vega J. SCATTER DOSE VALUES IN LOWER EXTREMITIES FOR STAFF DURING PAEDIATRIC INTERVENTIONAL CARDIOLOGY PROCEDURES: AN EXPERIMENTAL APPROACH. Radiation protection dosimetry 2017. link 29 Alejo L, Koren C, Corredoira E, Sánchez F, Bayón J, Serrada A et al.. Eye lens dose correlations with personal dose equivalent and patient exposure in paediatric interventional cardiology performed with a fluoroscopic biplane system. Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB) 2017. link 30 Ubeda C, Salazar L, Retana V, Santos F, Salvador L, Sáenz C et al.. CHARACTERIZATION AND EXPERIMENTAL MEASUREMENTS OF SCATTER DOSE AT CARDIOLOGIST'S EYES DURING PAEDIATRIC INTERVENTIONAL CARDIOLOGY PROCEDURES IN COSTA RICA. Radiation protection dosimetry 2017. link 31 Matthews L, Dixon M, Rowles N, Stevens G. A practical method for skin dose estimation in interventional cardiology based on fluorographic DICOM information. Radiation protection dosimetry 2016. link 32 Kiramijyan S, Didier R, Koifman E, Negi SI. What should a fellow-in-training expect at national cardiovascular conferences? The interventional cardiology fellows' perspective. Cardiovascular revascularization medicine : including molecular interventions 2016. link 33 Domienik J, Bissinger A, Grabowicz W, Jankowski Ł, Kręcki R, Makowski M et al.. The impact of various protective tools on the dose reduction in the eye lens in an interventional cardiology-clinical study. Journal of radiological protection : official journal of the Society for Radiological Protection 2016. link 34 Kaljevic J, Ciraj-Bjelac O, Stankovic J, Arandjic D, Bozovic P, Antic V. OCCUPATIONAL DOSE ASSESSMENT IN INTERVENTIONAL CARDIOLOGY IN SERBIA. Radiation protection dosimetry 2016. link 35 Sánchez RM, Vano E, Fernández JM, Pifarré X, Ordiales JM, Rovira JJ et al.. Occupational eye lens doses in interventional cardiology. A multicentric study. Journal of radiological protection : official journal of the Society for Radiological Protection 2016. link 36 Vano E, Sanchez RM, Fernandez JM. Estimation of staff lens doses during interventional procedures. Comparing cardiology, neuroradiology and interventional radiology. Radiation protection dosimetry 2015. link 37 Leuenberger R, Meade JA. Managing uncertainty in complex interventional fluoroscopic procedures. Health physics 2014. link 38 Abatzoglou I, Koukourakis M, Konstantinides S. Reduction of the radiation dose received by interventional cardiologists following training in radiation protection. Radiation protection dosimetry 2013. link 39 Durán A, Hian SK, Miller DL, Le Heron J, Padovani R, Vano E. A summary of recommendations for occupational radiation protection in interventional cardiology. Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions 2013. link 40 Kesavachandran CN, Haamann F, Nienhaus A. Radiation exposure and adverse health effects of interventional cardiology staff. Reviews of environmental contamination and toxicology 2013. link 41 Ubeda C, Vano E, Miranda P, Leyton F, Valenzuela E, Oyarzun C. Radiation dose and image quality for adult interventional cardiology in Chile: a national survey. Radiation protection dosimetry 2011. link 42 Ciraj-Bjelac O, Beganović A, Faj D, Ivanovic S, Videnovic I, Rehani M. Status of radiation protection in interventional cardiology in four East European countries. Radiation protection dosimetry 2011. link 43 Ubeda C, Vano E, Miranda P, Leyton F, Martinez LC, Oyarzun C. Radiation dose and image quality for paediatric interventional cardiology systems. A national survey in Chile. Radiation protection dosimetry 2011. link 44 Sánchez R, Vano E, Fernández JM, Sotil J, Carrera F, Armas J et al.. A national programme for patient and staff dose monitoring in interventional cardiology. Radiation protection dosimetry 2011. link 45 Padovani R, Le Heron J, Cruz-Suarez R, Duran A, Lefaure C, Miller DL et al.. International project on individual monitoring and radiation exposure levels in interventional cardiology. Radiation protection dosimetry 2011. link 46 Best PJ, Skelding KA, Mehran R, Chieffo A, Kunadian V, Madan M et al.. SCAI consensus document on occupational radiation exposure to the pregnant cardiologist and technical personnel. Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions 2011. link 47 Best PJ, Skelding KA, Mehran R, Chieffo A, Kunadian V, Madan M et al.. SCAI consensus document on occupational radiation exposure to the pregnant cardiologist and technical personnel. EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology 2011. link 48 Best PJ, Skelding KA, Mehran R, Chieffo A, Kunadian V, Madan M et al.. SCAI consensus document on occupational radiation exposure to the pregnant cardiologist and technical personnel. Heart, lung & circulation 2011. link 49 Vano E, Ubeda C, Leyton F, Miranda P, Gonzalez L. Staff radiation doses in interventional cardiology: correlation with patient exposure. Pediatric cardiology 2009. link 50 Klein LW, Miller DL, Balter S, Laskey W, Haines D, Norbash A et al.. Occupational health hazards in the interventional laboratory: time for a safer environment. Radiology 2009. link 51 Foti C, Padovani R, Trianni A, Bokou C, Christofides S, Corbett RH et al.. Staff dosimetry in interventional cardiology: survey on methods and level of exposure. Radiation protection dosimetry 2008. link 52 Dowling A, Gallagher A, O'Connor U, Larkin A, Gorman D, Gray L et al.. Acceptance testing and QA of interventional cardiology systems. Radiation protection dosimetry 2008. link 53 Lie ØØ, Paulsen GU, Wøhni T. Assessment of effective dose and dose to the lens of the eye for the interventional cardiologist. Radiation protection dosimetry 2008. link 54 Tsapaki V, Patsilinakos S, Voudris V, Magginas A, Pavlidis S, Maounis T et al.. Level of patient and operator dose in the largest cardiac centre in Greece. Radiation protection dosimetry 2008. link 55 Tsapaki V, Kottou S, Patsilinakos S, Voudris V, Cokkinos DV. Radiation dose measurements to the interventional cardiologist using an electronic personal dosemeter. Radiation protection dosimetry 2004. link 56 Guibelalde E, Vano E, Gonzalez L, Prieto C, Fernandez JM, Ten JI. Short communication: Practical aspects for the evaluation of skin doses in interventional cardiology using a new slow film. The British journal of radiology 2003. link 57 Padovani R, Rodella CA. Staff dosimetry in interventional cardiology. Radiation protection dosimetry 2001. link 58 Neofotistou V. Review of patient dosimetry in cardiology. Radiation protection dosimetry 2001. link 59 Idée JM, Corot C. Thrombotic risk associated with the use of iodinated contrast media in interventional cardiology: pathophysiology and clinical aspects. Fundamental & clinical pharmacology 1999. link 60 Cardella JF, Kotula F, Hunter DW, Young AT, Castaneda-Zuniga WR, Amplatz K. Very stiff guide wire with a floppy tip. Radiology 1985. link

    Original source

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      From Representation to Reform: A Qualitative Study of Gender Equity in Interventional Cardiology. — Alexandrou M, Alexandrou D, Kearney KE, Guerrero M, Karacsonyi J, Hall AB et al. The American journal of cardiology (2026)
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      Understanding the Canadian Interventional Radiology Landscape Through the Canadian Association of Interventional Radiology Database: A Descriptive Study. — Dhatt A, de Korompay N, Heran MKS, Chang MR, Ho S, Liu DM et al. Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes (2026)
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      Women's Representation in Interventional Cardiology and Other Interventional Fields: Opportunities and Challenges. — Çetinarslan Ö, Acar Ş, Sönmez IY, Zoghi M Anatolian journal of cardiology (2025)
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      A report on a survey among Portuguese Association of Interventional Cardiology associates regarding ionizing radiation protection practices in national interventional cath-labs. — Costa H, Vinhas H, Calé R, Pereira E, Santos J, Paulo G et al. Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology (2024)
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      A 17-Years Follow-up of Occupational Radiation Doses in an Interventional Cardiology Department. — Kostova-Lefterova D, Mateev H, Aleksandrov A, Ivanova E, Vladimirov G, Bankova A et al. Current medical imaging (2024)
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      Establishing a priori and a posteriori predictive models to assess patients' peak skin dose in interventional cardiology. Part 2: results of the VERIDIC project. — Feghali JA, Delépierre J, Belac OC, Dabin J, Deleu M, De Monte F et al. Acta radiologica (Stockholm, Sweden : 1987) (2023)
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      Radiation protection for healthcare professionals working in catheterisation laboratories during pregnancy: a statement of the European Association of Percutaneous Cardiovascular Interventions (EAPCI) in collaboration with the European Heart Rhythm Association (EHRA), the European Association of Cardiovascular Imaging (EACVI), the ESC Regulatory Affairs Committee and Women as One. — Manzo-Silberman S, Velázquez M, Burgess S, Sahni S, Best P, Mehran R et al. EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology (2023)
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