Pre-operative assessment and management of the patient with ischaemic coronary artery disease in non-cardiac surgery.
Peri-operative cardiac events are the leading cause of death following anaesthesia and surgery. We attempt to put into perspective the various methods of pre-operative assessment of patients at risk, and suggest a logical sequence for the use of potentially costly investigations such as 12-lead ECG, exercise stress ECG, ambulatory ECG monitoring, myocardial perfusion imaging, radionuclide ejection fraction, and coronary angiography. Important principles are given for the management of patients at risk of peri-operative cardiac incidents if the decision is made to proceed with non-cardiac surgery despite the potential risk or because of inoperable coronary disease.
van der Merwe
W L
WL
Department of Anaesthesiology, University of Stellenbosch, Parowvallei, CP.
Coetzee
A R
AR
D003327:Coronary Disease / Q000175:diagnosis*; D004562:Electrocardiography; D006801:Humans; D017202:Myocardial Ischemia / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care; D013514:Surgical Procedures, Operative