Editorial

Orthopaedic cardiac considerations in emergency

¹ Department of Emergency Medicine and Cardiology, National and Kapodistrian University of Athens, 11527 Athens, Greece
² Second Department of Anesthesiology, National and Kapodistrian University of Athens, 11527 Athens, Greece
³ First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, 11527 Athens, Greece

^* Corresponding author: afm@otenet.gr

Received: 18 September 2021
Accepted: 7 October 2021

Abstract

Orthopaedic patients undergoing emergency orthopaedic surgery should be referred for cardiac evaluation only when they are symptomatic or when a specific cardiac intervention is expected to reduce the surgical risk. A preoperative delay of 24–48 h of emergency orthopaedic operations has been associated with increased mortality and poor functional status of the patients. Research in the preoperative setting is almost exclusively retrospective because randomized studies are difficult to be performed and pose serious ethical concerns. Moreover, inevitably, guidelines have a low level of evidence and do not always provide a straightforward framework for the preoperative care of the patients. This editorial revisits the most common clinical cardiology dilemmas for emergency orthopaedic surgery to explore controversies of current recommendations and elaborate on the role of echocardiography in the perioperative period in emergency orthopaedic surgery.