Preoperative assessment of cardiac risk and perioperative cardiac management in noncardiac surgery

More than 27 million Americans undergo noncardiac surgery annually. Cardiac complications can be a major source of morbidity and mortality in the perioperative period. Preoperative risk stratification, intraoperative ischemia monitoring and postoperative surveillance help to predict, identify and efficiently treat these adverse events. A renewed emphasis on preoperative evaluation has helped to identify patients at an increased risk for adverse cardiac events and thus, implement noninvasive or invasive cardio protective strategies in an attempt to minimize these complications. In this review we briefly describe the current evidence on perioperative management of patients presenting for noncardiac surgery. As the surgeon will remain one of the first to evaluate patients before noncardiac surgery it is essential he/she be well versed with this information.