Arrhythmias, Acute Coronary Syndromes, and Hypertensive Emergencies

This is a unique question-and-answer chapter for surgical residents and trainees, concentrating on the arrhythmias, acute coronary syndromes, and hypertensive emergencies. Takotsubo's syndrome or broken heart syndrome is a transient cardiomyopathy that causes significant cardiac depression and closely resembles acute coronary syndromes. Patients typically present with respiratory failure after a significant upper airway problem with EKG changes including ST segment elevation and T wave inversion, and mildly elevated cardiac enzymes. According to recent guidelines, in patients with acute coronary syndrome treated with bare metal or drug eluting stent implantation, dual antiplatelet therapy (DAPT) with aspirin and clopidogrel, prasugrel, or ticagrelor should be continued for at least 12 months. Elective noncardiac surgeries should be delayed in order to complete a full year of DAPT. Betablockers are drugs of choice for patients with long QT syndrome, which is the most common type of inherited arrhythmia.