Preoperative cardiac evaluation and management of patients undergoing elective non-cardiac surgery.
Perioperative cardiac complications are a common cause of death and major morbidity in patients undergoing non-cardiac surgery. Preoperative evaluation and medical optimisation can improve outcomes, although the evidence base is limited. Evidence of effectiveness is strongest for prophylactic use of β-blockers in high-risk patients and aspirin in patients with coronary artery disease. Particular challenges arise among patients with heart failure or valvular heart disease or those receiving antithrombotic therapy for coronary artery stents or atrial fibrillation. Close liaison between general practitioners, surgeons, anaesthetists and cardiologists is needed for optimising preoperative management and subsequent clinical outcomes in high-risk patients.
Internal Medicine and Clinical Epidemiology, Princess Alexandra Hospital, Brisbane, QLD, Australia. ian.scott@health.qld.gov.au.
Ian A
IA
Scott
Hasan A
HA
Shohag
Peter C A
PC
Kam
Michael V
MV
Jelinek
Golam M
GM
Khadem
D002317:Cardiovascular Agents / Q000627:therapeutic use; D003661:Decision Support Techniques; D017558:Elective Surgical Procedures; D006305:Health Status Indicators; D006331:Heart Diseases / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy; D006801:Humans; D062645:Percutaneous Coronary Intervention; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy; D011300:Preoperative Care / Q000379:methods*; D020379:Risk Adjustment; D018570:Risk Assessment; D012307:Risk Factors
D002317:Cardiovascular Agents