title: Preoperative Assessment of the Patient with Cardiac Disease Undergoing Noncardiac Surgery.
abstract: The American College of Cardiology/American Heart Association has published Guidelines on Perioperative Evaluation. Preoperative evaluation should focus on identifying patients with symptomatic and asymptomatic coronary artery disease. The guidelines advocate using the American College of Surgeons National Surgical Quality Improvement Project Risk Index to determine perioperative risk. Diagnostic testing should be reserved for those at increased risk with poor exercise capacity. Indications for coronary interventions are the same in the perioperative period as in the nonoperative setting. In patients with a prior coronary stent, optimal antiplatelet therapy and timing of elective noncardiac surgery is evolving.
authors.affiliation: Department of Anesthesiology and Critical Care, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19437, USA. Electronic address: Lee.fleisher@uphs.upenn.edu.
authors.forename: Lee A
authors.initials: LA
authors.lastname: Fleisher
mesh_terms: D017408:Guidelines as Topic; D006331:Heart Diseases / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D019990:Perioperative Care; D011300:Preoperative Care; D057234:Preoperative Period; D018570:Risk Assessment; D013514:Surgical Procedures, Operative / Q000379:methods*
keywords: Cardiac; Coronary revascularization; Myocardial infarction; Preoperative; Stress testing