Cardiovascular risk management in the peri-operative setting

Area of Science:

• Cardiology
• Anesthesiology
• Peri-operative Medicine

Background:

• Peri-operative cardiovascular events affect up to 3% of patients undergoing non-cardiac surgery.
• Effective cardiovascular risk assessment is vital for informed decision-making, surgical planning, and preventive strategies.

Purpose of the Study:

• To outline the importance and methods of pre-operative cardiovascular risk assessment.
• To guide the appropriate use of cardiac investigations and interventions.

Main Methods:

• Clinical assessment, including functional capacity estimation, is the cornerstone of pre-operative risk evaluation.
• Specialized cardiac investigations are generally not indicated solely for risk assessment.
• Decisions on investigations depend on surgery type, extent, and urgency.

Main Results:

• Quantitative risk assessment can influence surgical approach and management choices.
• Pre-operative revascularization is not evidence-based for improving post-operative outcomes.

Conclusions:

• Pre-operative cardiovascular risk assessment should prioritize clinical evaluation and functional capacity.
• Routine pre-operative revascularization is not advised; investigations should be judiciously applied.