Cardiac Management of Noncardiac Sx Guidelines Issues
(HealthDay News) — Recommendations have been developed for perioperative cardiovascular management of patients undergoing noncardiac surgery. These revised guidelines were published online August 1 in the Journal of the American College of Cardiology.
Lee A. Fleisher, MD, from the University of Pennsylvania Health System in Philadelphia, and colleagues reviewed the literature and developed guidelines for perioperative cardiovascular evaluation and management of adult patients undergoing noncardiac surgery.
According to the guidelines, a validated risk prediction tool can be used to predict the risk of perioperative major adverse cardiovascular events (MACE); patients with low risk of perioperative MACE do not need further testing. Preoperative resting 12-lead electrocardiogram is reasonable for patients with known coronary heart disease or other heart conditions, and may be considered for asymptomatic patients without known coronary heart disease. Assessment of left ventricular function is recommended for certain patients, but routine evaluation is not recommended. Exercise and stress testing should be considered for patients with elevated risk, but routine screening is not recommended. Patients who have been on beta-blockers chronically should continue therapy. Management of beta-blockers should be guided by clinical circumstances.
"Ensuring that patients are receiving high-quality cardiovascular care prior to noncardiac surgery and continuing that care throughout the perioperative period are crucial in minimizing the risk of surgery," a coauthor said in a statement.
Several authors disclosed financial ties to the pharmaceutical industry.