Provides expert recommendations on preoperative management and prophylactic digitalization for cardiac patients undergoing noncardiac surgery.
May guide preoperative digitalization in select high-risk patients; leaves open need for randomized confirmation of recommendations.
Noncardiac surgery is not contraindicated in most cardiacs, but many require special preoperative management, particularly in regard to medications. Even when there is no evidence of myocardial dysfunction or congestive heart failure, digitalization is recommended in the patient over 65 years old or with frequent junctional or atrial premature beats or tachycardia, paroxysmal atrial fibrillation or flutter, coronary atherosclerotic heart disease, or a history of heart failure. Patients with class IV function should have surgery only in an emergency.
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Peter C. Gazes (1971) studied this question.
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