ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: Executive Summary

Lee A. FleisherProfessor of Anesthesiology, University of Pennsylvania

“Make sure that you're giving the right amount and monitoring their blood pressure and heart rate. Really think once, twice, and thrice about starting a protocol.”

“Physicians may struggle with implementing these evidence-based guidelines for a variety of reasons, including legal concerns regarding pre-operative cardiac events, pressure from surgical colleagues and reliance on testing and procedures for income. It's imperative that any form of health care reform provide incentives to follow these guidelines. It is the quality of care, not the quantity of tests, that matters most.”

“It appears that many noninvasive stress tests are not only unnecessary, but potentially misleading. Occasionally such testing may lead to unnecessary invasive testing which has its own set of risks, or unnecessary medical treatment which also has some risks attached.”