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Med Clin North Am. 2003 Jan;87(1):111-36.

Preoperative risk evaluation and perioperative management of patients with coronary artery disease.

Author information

1
Division of General Internal Medicine, State University of New York, Downstate Medical Center, 470 Clarkson Avenue, Box 68, Brooklyn, NY 11203, USA. steven_cohn@downstate.edu

Abstract

We have reviewed the methods of evaluating a patient's cardiac risk preoperatively using a careful history, physical examination, and EKG. Based on this information, various risk indices, guidelines, and algorithms can further assist the physician in deciding which patients can undergo surgery without further testing and which patients might benefit from further cardiac evaluation or medical therapy prior to surgery. The physician must keep in mind that a test should not be ordered if it is unlikely to alter the patient's management, and it is rarely necessary to perform a revascularization procedure with the sole purpose of getting a patient through surgery. Ongoing research is likely to lead to improvement in perioperative medical therapy.

PMID:
12575886
DOI:
10.1016/s0025-7125(02)00143-8
[Indexed for MEDLINE]

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