Noncardiac Surgery in the Patient with Heart Disease

James B. Froehlich, Lee A. Fleisher

Research output: Contribution to journalArticle

Abstract

Clinicians are increasingly asked what they can do to evaluate and lower the risk of perioperative cardiac complications. Approximately 4 decades ago, there were few tools to guide the evaluation of perioperative risk. The American Society of Anesthesiology Classification System (ASA class) gave only a vague idea of the risk patients faced during surgery, but the modern era of clinical risk assessment for perioperative complications has seen the introduction of tools that allow clinicians to estimate risk, and also the addition of stress testing for assessing perioperative risk. None of these tests, however, were designed to identify perioperative cardiac risk. This article reviews the literature on perioperative risk assessment, risk reduction, and testing modalities in patients with cardiac disease, along with the role of perioperative angioplasty and the current American College of Cardiology/American Heart Association guidelines.

Original languageEnglish (US)
Pages (from-to)995-1016
Number of pages22
JournalMedical Clinics of North America
Volume93
Issue number5
DOIs
StatePublished - Sep 2009
Externally publishedYes

Fingerprint

Heart Diseases
Anesthesiology
Risk Reduction Behavior
Angioplasty
Guidelines

Keywords

  • Perioperative
  • Pre-operative
  • Risk
  • Surgery

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Noncardiac Surgery in the Patient with Heart Disease. / Froehlich, James B.; Fleisher, Lee A.

In: Medical Clinics of North America, Vol. 93, No. 5, 09.2009, p. 995-1016.

Research output: Contribution to journalArticle

Froehlich, James B. ; Fleisher, Lee A. / Noncardiac Surgery in the Patient with Heart Disease. In: Medical Clinics of North America. 2009 ; Vol. 93, No. 5. pp. 995-1016.
@article{7f946ffa48e44f23a75ccf727123b1ee,
title = "Noncardiac Surgery in the Patient with Heart Disease",
abstract = "Clinicians are increasingly asked what they can do to evaluate and lower the risk of perioperative cardiac complications. Approximately 4 decades ago, there were few tools to guide the evaluation of perioperative risk. The American Society of Anesthesiology Classification System (ASA class) gave only a vague idea of the risk patients faced during surgery, but the modern era of clinical risk assessment for perioperative complications has seen the introduction of tools that allow clinicians to estimate risk, and also the addition of stress testing for assessing perioperative risk. None of these tests, however, were designed to identify perioperative cardiac risk. This article reviews the literature on perioperative risk assessment, risk reduction, and testing modalities in patients with cardiac disease, along with the role of perioperative angioplasty and the current American College of Cardiology/American Heart Association guidelines.",
keywords = "Perioperative, Pre-operative, Risk, Surgery",
author = "Froehlich, {James B.} and Fleisher, {Lee A.}",
year = "2009",
month = "9",
doi = "10.1016/j.mcna.2009.05.012",
language = "English (US)",
volume = "93",
pages = "995--1016",
journal = "Medical Clinics of North America",
issn = "0025-7125",
publisher = "W.B. Saunders Ltd",
number = "5",

}

TY - JOUR

T1 - Noncardiac Surgery in the Patient with Heart Disease

AU - Froehlich, James B.

AU - Fleisher, Lee A.

PY - 2009/9

Y1 - 2009/9

N2 - Clinicians are increasingly asked what they can do to evaluate and lower the risk of perioperative cardiac complications. Approximately 4 decades ago, there were few tools to guide the evaluation of perioperative risk. The American Society of Anesthesiology Classification System (ASA class) gave only a vague idea of the risk patients faced during surgery, but the modern era of clinical risk assessment for perioperative complications has seen the introduction of tools that allow clinicians to estimate risk, and also the addition of stress testing for assessing perioperative risk. None of these tests, however, were designed to identify perioperative cardiac risk. This article reviews the literature on perioperative risk assessment, risk reduction, and testing modalities in patients with cardiac disease, along with the role of perioperative angioplasty and the current American College of Cardiology/American Heart Association guidelines.

AB - Clinicians are increasingly asked what they can do to evaluate and lower the risk of perioperative cardiac complications. Approximately 4 decades ago, there were few tools to guide the evaluation of perioperative risk. The American Society of Anesthesiology Classification System (ASA class) gave only a vague idea of the risk patients faced during surgery, but the modern era of clinical risk assessment for perioperative complications has seen the introduction of tools that allow clinicians to estimate risk, and also the addition of stress testing for assessing perioperative risk. None of these tests, however, were designed to identify perioperative cardiac risk. This article reviews the literature on perioperative risk assessment, risk reduction, and testing modalities in patients with cardiac disease, along with the role of perioperative angioplasty and the current American College of Cardiology/American Heart Association guidelines.

KW - Perioperative

KW - Pre-operative

KW - Risk

KW - Surgery

UR - http://www.scopus.com/inward/record.url?scp=68149182840&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=68149182840&partnerID=8YFLogxK

U2 - 10.1016/j.mcna.2009.05.012

DO - 10.1016/j.mcna.2009.05.012

M3 - Article

C2 - 19665616

AN - SCOPUS:68149182840

VL - 93

SP - 995

EP - 1016

JO - Medical Clinics of North America

JF - Medical Clinics of North America

SN - 0025-7125

IS - 5

ER -