[The surgical risk in patients with cardiac diseases]

The increase in the number of patients with heart and circulatory diseases during selective surgical operations in the past decades is due to both the epidemiologic situation and the increase in the number of old and very old people. To ensure optimum perioperative care of these patients, the anaesthetist must know the degree of illness of each individual and the functioning state of the haemodynamic system. In this paper we show factors which increase the perioperative risk of cardiac complications. These factors are traceable on a semiquantitative basis by the remaining function of the myocardium or the risk of ischaemia of the cardiac muscle. Many clinical symptoms or diagnoses do not affect the perioperative risk. To judge preoperative risks and specific perioperative changes in medication, cooperation between the anaesthetist and cardiologist is required.