Management of specific medical conditions in the perioperative period

Patients with a variety of medical conditions known to increase cardiovascular risk may require noncardiac surgery. After a preoperative assessment of risk, specific attention to medical therapy may be indicated in the perioperative period. The perioperative period begins before surgery when routine medical therapy may be interrupted, and continues through the surgical procedure and convalescence. During these times, the surgical patient is exposed to increased risks related to the underlying disease process prompting surgery, stresses associated with anesthesia, surgical intervention and postoperative discomfort, and alterations in usual medical therapy. With careful attention to risks specific to an underlying medical condition, patient monitoring and medical management in the perioperative period can be modified to prevent or minimize the impact of an adverse cardiac event.