Preoperative cardiac evaluation.
Guidelines on perioperative cardiovascular evaluation for noncardiac surgery have been published. The integration of clinical risk factors, surgery-specific risk,and functional capacity should be used to determine the need for further diagnostic evaluation. The use of beta-adrenergic blockade in high-risk patients,particularly those with documented myocardium at risk undergoing vascular surgery, has been shown to reduce perioperative risk and may obviate the need for more invasive procedures. Coronary intervention should be reserved for those patients who warrant intervention independent of the noncardiac surgery.
Fleisher
Lee A
LA
Department of Anesthesia, University of Pennsylvania School of Medicine, 3400 Spruce Street, Dulles 680, Philadelphia, PA 19104, USA. fleishel@uphs.upenn.edu
D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis; D017408:Guidelines as Topic; D006331:Heart Diseases / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D006334:Heart Function Tests; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology; D011300:Preoperative Care; D012307:Risk Factors