Current Practice and Recommendation for Presurgical Cardiac Evaluation in Patients Undergoing Noncardiac Surgeries

The increasing number of patients with coronary artery disease (CAD) undergoing major noncardiac surgery justifies guidelines concerning preoperative cardiac evaluation. This is compounded by increasing chances for a volatile perioperative period if the underlying cardiac problems are left uncorrect...

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Main Authors: Subramanyam Padma, P Sundaram
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2014-01-01
Series:World Journal of Nuclear Medicine
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.4103/1450-1147.138568
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author Subramanyam Padma
P Sundaram
author_facet Subramanyam Padma
P Sundaram
author_sort Subramanyam Padma
collection DOAJ
description The increasing number of patients with coronary artery disease (CAD) undergoing major noncardiac surgery justifies guidelines concerning preoperative cardiac evaluation. This is compounded by increasing chances for a volatile perioperative period if the underlying cardiac problems are left uncorrected prior to major noncardiac surgeries. Preoperative cardiac evaluation requires the clinician to assess the patient′s probability to have CAD, severity and stability of CAD, placing these in perspective regarding the likelihood of a perioperative cardiac complication based on the planned surgical procedure. Coronary events like new onset ischemia, infarction, or revascularization, induce a high-risk period of 6 weeks, and an intermediate-risk period of 3 months before performing noncardiac surgery. This delay is unwarranted in cases where surgery is the mainstay of treatment. The objective of this review is to offer a comprehensive algorithm in the preoperative assessment of patients undergoing noncardiac surgery and highlight the importance of myocardial perfusion imaging in risk stratifying these patients.
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spelling doaj-art-67a50b8911654003bee2b381cbddb3712025-08-20T02:54:43ZengThieme Medical and Scientific Publishers Pvt. Ltd.World Journal of Nuclear Medicine1450-11471607-33122014-01-01130161510.4103/1450-1147.138568Current Practice and Recommendation for Presurgical Cardiac Evaluation in Patients Undergoing Noncardiac SurgeriesSubramanyam Padma0P Sundaram1Department of Nuclear Medicine and PETCT, Amrita Institute of Medical Sciences, Cochin, Kerala, IndiaDepartment of Nuclear Medicine and PETCT, Amrita Institute of Medical Sciences, Cochin, Kerala, IndiaThe increasing number of patients with coronary artery disease (CAD) undergoing major noncardiac surgery justifies guidelines concerning preoperative cardiac evaluation. This is compounded by increasing chances for a volatile perioperative period if the underlying cardiac problems are left uncorrected prior to major noncardiac surgeries. Preoperative cardiac evaluation requires the clinician to assess the patient′s probability to have CAD, severity and stability of CAD, placing these in perspective regarding the likelihood of a perioperative cardiac complication based on the planned surgical procedure. Coronary events like new onset ischemia, infarction, or revascularization, induce a high-risk period of 6 weeks, and an intermediate-risk period of 3 months before performing noncardiac surgery. This delay is unwarranted in cases where surgery is the mainstay of treatment. The objective of this review is to offer a comprehensive algorithm in the preoperative assessment of patients undergoing noncardiac surgery and highlight the importance of myocardial perfusion imaging in risk stratifying these patients.http://www.thieme-connect.de/DOI/DOI?10.4103/1450-1147.138568cardiac risk stratificationcoronary artery diseaseheartnoncardiac surgeriesstress myocardial perfusion imagingsurgery
spellingShingle Subramanyam Padma
P Sundaram
Current Practice and Recommendation for Presurgical Cardiac Evaluation in Patients Undergoing Noncardiac Surgeries
World Journal of Nuclear Medicine
cardiac risk stratification
coronary artery disease
heart
noncardiac surgeries
stress myocardial perfusion imaging
surgery
title Current Practice and Recommendation for Presurgical Cardiac Evaluation in Patients Undergoing Noncardiac Surgeries
title_full Current Practice and Recommendation for Presurgical Cardiac Evaluation in Patients Undergoing Noncardiac Surgeries
title_fullStr Current Practice and Recommendation for Presurgical Cardiac Evaluation in Patients Undergoing Noncardiac Surgeries
title_full_unstemmed Current Practice and Recommendation for Presurgical Cardiac Evaluation in Patients Undergoing Noncardiac Surgeries
title_short Current Practice and Recommendation for Presurgical Cardiac Evaluation in Patients Undergoing Noncardiac Surgeries
title_sort current practice and recommendation for presurgical cardiac evaluation in patients undergoing noncardiac surgeries
topic cardiac risk stratification
coronary artery disease
heart
noncardiac surgeries
stress myocardial perfusion imaging
surgery
url http://www.thieme-connect.de/DOI/DOI?10.4103/1450-1147.138568
work_keys_str_mv AT subramanyampadma currentpracticeandrecommendationforpresurgicalcardiacevaluationinpatientsundergoingnoncardiacsurgeries
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