title: Perioperative assessment and management of patients with coronary artery disease.
abstract: Primary care physicians, surgeons, and anesthesiologists are all involved in assessing patients before surgery. The medical literature describes techniques to identify high-risk cardiac patients before elective surgery and strategies to reduce risk once these patients have been identified. Multifactorial indices can identify high-risk patients undergoing nonvascular surgery. Selective use of dipyridamole-thallium imaging based on clinical factors will identify high-risk patients before vascular surgery. Once high-risk patients have been identified, risk reduction can be attempted in various ways. We have no convincing evidence that prophylactic revascularization benefits high-risk patients. Perioperative beta-blockade reduces perioperative myocardial ischemia, mortality, and the incidence of cardiovascular complications for up to 2 years. Therefore, perioperative beta-blockers are recommended for high-risk patients undergoing elective noncardiac surgery.
authors.affiliation: University of Washington School of Medicine, Spokane, USA. potykd@shmc.org
authors.forename: D K
authors.initials: DK
authors.lastname: Potyk
mesh_terms: D003327:Coronary Disease / Q000175:diagnosis / Q000601:surgery*; D017558:Elective Surgical Procedures; D006801:Humans; D019990:Perioperative Care / Q000379:methods / Q000592:standards; D011183:Postoperative Complications / Q000517:prevention & control*; D018570:Risk Assessment; D016896:Treatment Outcome