[Preoperative evaluation of patients with ischemic heart disease]

Perioperative myocardial infarction is associated with significant perioperative mortality and morbidity. Sys tematic approach including basic clinical assessment obtained by history, physical examinations and bio chemical tests is necessary for the appropriate evalua tion of patients with ischemic heart disease. Discontinuation of antiplatelet therapy increases the risk of cardiac events in the patients until at least 12 months after implantation of drug-eluting stent. If noncardiac surgery is planned within 12 months, drug-eluting stent should not be indicated. Cardioprotective effects of volatile anesthetic agents are beneficial for mainte nance of general anesthesia in hemodynamically stable patients at risk of myocardial ischemia.