Cardiac risk evaluation and management in noncardiac surgery.
A careful history, physical examination, resting electrocardiogram, and chest radiograph are essential for preoperative cardiac assessment of adult patients. The nine individual Goldman indicators of increased perioperative cardiac risk and evidence of an unstable coronary ischemic syndrome should be specifically sought in each patient and treated when possible. After initial assessment, patients who still have a medium level of perioperative risk can usually be accurately assigned to a high- or low-risk category through the use of exercise testing and the selective use of dipyridamole thallium imaging.
Department of Internal Medicine, University of Cincinnati School of Medicine, Ohio.
M C
MC
Gerson
D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000758:Anesthesia; D003327:Coronary Disease / Q000453:epidemiology; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006331:Heart Diseases / Q000453:epidemiology*; D006334:Heart Function Tests; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D011300:Preoperative Care; D011877:Radionuclide Imaging; D012307:Risk Factors; D013514:Surgical Procedures, Operative