Cardiac Biomarkers and Perioperative Management of Right Ventricular Failure

From the World Congress of Anesthesiologists in Marrakech, TopMedTalk hosts Mike Grocott and Kate Leslie discuss perioperative cardiac risk assessment with Hilary Grocott, Professor and Head of, The Department of Anesthesiology, Pharmacology & Therapeutics (University of British Columbia) and Michelle Chew Professor of Anesthesiology and Intensive Care Medicine at Karolinska Institutet, Stockholm, Sweden, and editor for the British Journal of Anaesthesia. The conversation reviews perioperative cardiac biomarkers, noting abundant prognostic data but limited evidence for biomarker-led management. The discussion emphasizes that elevated troponins can reflect non-cardiac complications (AKI, PE, sepsis) as well as myocardial injury or heart failure, requiring context-specific follow-up pathways. The group highlights NT-proBNP as a specific marker for heart failure and useful for screening and optimization. The podcast then focuses on pulmonary hypertension and failing right ventricle: detect via history, exam, echo, and biomarkers; prioritize preemptive preparation, arterial beat-to-beat monitoring, modest fluids, early vasopressors/inotropes (norepinephrine, low-dose epinephrine), ventilatory optimization, and vigilant, rapid intervention. If you enjoyed this piece there's a fantastic Perioperative Profile with Michelle Chew you can hear here: https://topmedtalk.libsyn.com/perioperative-profiles-professor-michelle-chew-on-seizing-opportunities-in-anaesthesia-research-editing-and-guideline-work -- Join us at Evidence Based Perioperative Medicine (EBPOM) World Congress 2026 in London. Be part of a global conversation as clinicians from around the world gather between 7-9th July at the British Library in London. Three days of evidence-based perioperative medicine, global insights, and expert debate—featuring speakers including Michael Marmot and Ken Rockwood. Register here - https://ebpom.org/product/ebpom-world-congress-2026/