How is preoperative cardiac risk assessed?

Updated: Feb 04, 2019
  • Author: Davinder Jassal, MD; Chief Editor: William A Schwer, MD  more...
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Answer

Answer

A preoperative cardiac risk assessment involves obtaining a thorough history and physical examination, along with a baseline electrocardiogram. Established cardiac diseases, including IHD, hypertension, arrhythmia, valvular heart disease, CHF, and the presence of a pacemaker or implantable defibrillator should be sought as part of the patient's history.

A number of studies pertaining to cardiac risk stratification have been published over the past 3 decades, including the Goldman, Detsky, and Eagle indices. In 2002 and 2014, the ACC/AHA updated guidelines for the perioperative cardiovascular evaluation for noncardiac surgery. A stepwise strategy that includes the assessment of clinical markers, prior cardiac evaluation and management, functional capacity in mets, and surgery specific risk is followed. [6, 7]


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