Perioperative Management of Anesthesia in Patients With Cardiovascular Disease: A Review of Current Guidelines in the United States

Perioperative anesthesia management in cardiovascular disease (CVD) patients is an important and multifaceted process requiring careful planning, multidisciplinary coordination, and keen observance of evidence-based guidelines. Thus, owing to the increased incidence rate of perioperative complications, including postoperative and intraoperative hemodynamic instability, arrhythmias, and ischemic events, CVD patients are considered a representative group for comprehension of the broader influence of anesthesia on cardiovascular function. Anesthetic methods and agents affect hemodynamic stability and poor management might result in exacerbated complications. Therefore, the objective of this review is to evaluate and summarize the United States' guidelines on perioperative management of anesthesia in CVD patients, highlighting the best anesthesia practices, strategies for risk assessment, and evidence-based recommendations for optimizing patient outcomes and reducing perioperative complications. The research question the study seeks to answer is how the existing U.S. guidelines inform the perioperative management of anesthesia in CVD patients and what evidence-based interventions are proposed for the optimization of patient outcomes and reduction of perioperative complications. The study has reviewed guidelines developed by the American College of Cardiology (ACC) and the American Heart Association (AHA), which focus on aspects of perioperative anesthesia management, including perioperative risk assessment, hemodynamic management, and anesthetic techniques. The literature search was conducted on different online databases, including PubMed, Scopus, Web of Science, and Google Scholar, for published and peer-reviewed literature that focused on perioperative anesthesia management and guidelines in the United States. Moreover, the search strategy utilized the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in the selection and subsequent inclusion of articles for the review. The systematic review has disclosed that anesthesia is more than the observation of an unconscious patient, as the four key anesthesia components should be provided and managed with care, owing to anesthesia's potential adverse effects. While there is no universal agreement on the provision, development, and use of a general protocol, careful consideration of every type of anesthesia and the related effects on patients with CVD is important to the provision of safer and proper care.