Preoperative cardiac evaluation. Assessing risk before noncardiac surgery

Primary care physicians are often asked to evaluate a surgical candidate's cardiovascular and general health status. In some patients, history taking and physical examination provide enough information to assess risk for the proposed procedure. In others--especially those with cardiac risk factors--more extensive testing is required, such as electrocardiography, stress testing, or angiography. Once clearance for surgery has been given, primary care physicians can suggest risk-reduction strategies that may help to minimize perioperative morbidity or mortality.