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Overview of preoperative cardiac risk assessment


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Basic principles of assessing cardiac risk in patients undergoing noncardiac surgery. Audience: general internists and family practitioners. Watch my YouTube video describing these slides:

Published in: Education, Health & Medicine
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Overview of preoperative cardiac risk assessment

  1. 1. Overview of Preoperative Cardiac Risk Assessment for the General Internist Terry Shaneyfelt, MD, MPH Associate Professor, UAB Department of Medicine
  2. 2. Disclaimer • Adult patients, 50 yrs of age or older, undergoing noncardiac surgery • Unstable or new cardiac symptoms should be evaluated according to current guidelines
  3. 3. Cardiac Risk Assessment • Goals: 1. Assess cardiac risk of planned surgical procedure 2. Determine the need for changes in management 3. Identification of cardiovascular conditions or risk factors requiring longer-term management • 3 components: • History • Physical exam • Cardiac Testing
  4. 4. Take a good cardiac HISTORY Evaluation of the stability of known CAD
  5. 5. Functional Capacity From Eur Heart J.
  6. 6. Perform a careful cardiovascular EXAM Status/control of cardiovascular disease Detection of significant valvular disease Peripheral vascular disease
  7. 7. Predict Perioperative Cardiovascular • Revised cardiac risk index Risk • Gupta risk calculator (NSQIP)
  8. 8. Do I need to get a Preoperative ECG? Ann Surg 2007;246:165