Preoperative Assessment and Perioperative Management of Cardiovascular Risk

Schiefermueller, Juergen MD
Myerson, Saul MD
Handa, Ashok I. FRCS

¹SpR Cardiology, Northern Deanery, UK ²Department of Cardiology, John Radcliffe Hospital, University of Oxford, Oxford, UK ³ Nuffield Department of Surgery, John Radcliffe Hospital, Headington, Oxford, UK

Corresponding Author:

Juergen Schiefermueller, SpR Cardiology, Northern Deanery, UK

Angiology 64(2):p 146-150, February 2013. | DOI: 10.1177/0003319712440874

Abstract

Preoperative cardiovascular evaluation of patients scheduled to undergo surgery requires a multidisciplinary approach involving anesthetists, surgeons, and cardiologists. Within the last 5 to 10 years, there have been considerable scientific advances in this field, and the European Society of Cardiology (ESC) and the American College of Cardiology/American Heart Association(ACC/AHA) have updated their guidelines.Greater emphasis now lies on preoperative clinical risk stratification and less on routine cardiac testing. Prophylactic coronary revascularization is now also seen as rarely indicated simply to lower the risk of surgery.This review will give a brief summary of the guidelines and suggests a practical stepwise approach to evaluate the patient preoperatively.