Cardiac screening before noncardiac surgery.
Cardiovascular complications are infrequent but can result in significant morbidity following noncardiac surgery, especially in patients with peripheral vascular disease or increased age. All patients require some level of preoperative screening to identify and minimize immediate and future risk, with a careful focus on known coronary artery disease or risks for coronary artery disease and functional capacity. The 2007 American College of Cardiology/American Heart Association Guidelines are clear that noninvasive and invasive testing should be limited to circumstances in which results will clearly affect patient management or in which testing would otherwise be indicated. beta-Blocker therapy has become controversial in light of recent publications but should be continued in patients already on therapy, and started in patients with high cardiac risk undergoing intermediate- or high-risk surgery.
Williams
Freddie M
FM
Cardiovascular Medicine, University of Virginia Health System, 1215 Lee Street, Box 800158, Charlottesville, VA 22908, USA.
Bergin
James D
JD
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000150:complications / Q000175:diagnosis*; D015897:Comorbidity; D003955:Diagnostic Tests, Routine; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D010347:Patient Care Planning / Q000592:standards; D019990:Perioperative Care / Q000592:standards*; D011183:Postoperative Complications / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000592:standards*; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000009:adverse effects*; D014481:United States
D000319:Adrenergic beta-Antagonists; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors