What question did this study set out to answer?

To review clinical approaches for preoperative cardiac risk assessment in noncardiac surgery based on perioperative myocardial ischemia pathophysiology and recent trial evidence.

March 1, 1998Archives of Family Medicine

Preoperative Cardiac Evaluation for Elective Noncardiac Surgery

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To review clinical approaches for preoperative cardiac risk assessment in noncardiac surgery based on perioperative myocardial ischemia pathophysiology and recent trial evidence.
Conducted a MEDLINE database search followed by manual bibliography reviews of identified literature.
Synthesized evidence concerning multifactorial risk indexes, coronary artery disease, congestive heart failure, and valvular heart disease management.
Multifactorial risk indexes accurately stratify risk in general populations but underestimate risk in patients with peripheral vascular disease.
Patients with well-compensated congestive heart failure tolerate surgery safely, whereas those with aortic stenosis carry high risk requiring individualized intervention.
A targeted clinical history, physical examination, and selective diagnostic testing sufficiently identify modifiable cardiac risk factors prior to surgery.

Structured PICO

Population

Patients undergoing elective noncardiac surgery, including those with coronary artery disease, congestive heart failure, valvular heart disease, and peripheral vascular disease.

Intervention

Preoperative cardiac evaluation and risk assessment

A thorough history and physical examination are generally sufficient for preoperative cardiac risk assessment in patients undergoing elective noncardiac surgery.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Supports limiting routine preoperative labs in elective noncardiac surgery; leaves open need for prospective outcome validation.

Cite This Study

Darryl Potyk (1998) studied this question.

synapsesocial.com/papers/6a89227c7c664faad1126b7c https://doi.org/10.1001/archfami.7.2.164

Topics

Heart failure HFrEF treatment Valvular heart disease

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Preoperative Cardiac Evaluation for Elective Noncardiac Surgery

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Preoperative Cardiac Evaluation for Elective Noncardiac Surgery

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider