title: [Cardiovascular assessment and management before non-cardiac surgery].
abstract: The preoperative cardiovascular risk management accounts for patient-related risk factors, the circumstances leading to the surgical procedure, and the risk of the operation. While urgent operations should not be delayed for cardiac testing, an elective surgical intervention should be postponed in unstable cardiac conditions. In stable cardiac situations, prophylactic coronary interventions to reduce the risk of perioperative complications are rarely indicated. Therefore, in most cases, the planned operation can be performed without previous cardiac stress testing or coronary angiography. Preoperative imaging stress testing is recommended for patients with poor functional capacities that are at high cardiovascular risk prior to a high-risk operation. According to the literature, preoperative prophylactic administration of betablockers and aspirin is controversial. Preoperative discontinuation of dual anti-platelet therapy within six months following drug-eluting stent implantation is not recommended.
authors.affiliation: 1 Klinik für Kardiologie, Stadtspital Triemli, Zürich.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Schwarz
authors.forename: Alain M
authors.initials: AM
authors.lastname: Bernheim
mesh_terms: D000465:Algorithms; D002318:Cardiovascular Diseases / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D003955:Diagnostic Tests, Routine / Q000379:methods; D019983:Guideline Adherence; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods*; D018570:Risk Assessment / Q000379:methods*
keywords: Operationsrisiko; cardiovascular risk; complications périopératoires; kardiovaskuläres Risiko; perioperative Komplikationen; perioperative complications; preoperative risk stratification; präoperative Risikostratifizierung; risque cardiovasculaire; risque chirurgical; stratification du risque préopératoire; surgical risk