Preoperative risk evaluation and perioperative management of patients with coronary artery disease

Area of Science:

• Cardiology
• Anesthesiology
• Internal Medicine

Background:

• Preoperative cardiac risk assessment is crucial for patient safety.
• Identifying patients at high risk for cardiac events undergoing non-cardiac surgery is essential.

Purpose of the Study:

• To review current methods for preoperative cardiac risk evaluation.
• To guide physicians in decision-making regarding further cardiac testing or medical therapy before surgery.

Main Methods:

• Review of established methods including patient history, physical examination, and electrocardiogram (EKG).
• Application of various risk indices, clinical guidelines, and algorithms for risk stratification.

Main Results:

• A systematic approach using history, physical exam, and EKG can effectively stratify preoperative cardiac risk.
• Risk indices and guidelines aid in identifying patients who may require further cardiac evaluation or intervention.

Conclusions:

• Ordering tests should be guided by their potential to alter patient management.
• Revascularization solely for surgical clearance is rarely indicated.
• Further research into perioperative medical therapy promises improved patient outcomes.