Pre-operative cardiac assessment in non-cardiac surgery: a frequent dilemma simplified by a decision tree
Sierro, C.; Iglesias, J.F.; Eeckhout, E.; Vogt, P.
Revue Medicale Suisse 6(251): 1117-1121
2010
ISSN/ISBN: 1660-9379 PMID: 20572354 Document Number: 643689
In patients undergoing non-cardiac surgery, cardiac events are the most common cause of perioperative morbidity and mortality. It is often difficult to choose adequate cardiologic examinations before surgery. This paper, inspired by the guidelines of the European and American societies of cardiology (ESC, AHA, ACC), discusses the place of standard ECG, echocardiography, treadmill or bicycle ergometer and pharmacological stress testing in preoperative evaluations. The role of coronary angiography and prophylactic revascularization will also be discussed. Finally, we provide a decision tree which will be helpful to both general practitioners and specialists.