Affiliation:
1. Faculty of Medicine, Belgrade, Department of Cardiology, Clinical Hospital Zemun
2. Department of Vascular Surgery, Erasmus Medical Center, Rotterdam, Netherlands
3. Department of Cardiology, Clinical Hospital Zemun, Faculty of Medicine, Belgrade
Abstract
Approximately 100 million people undergo noncardiac surgery annually
worldwide. It is estimated that around 3% of patients undergoing noncardiac
surgery experience a major adverse cardiac event. Although cardiac events,
like myocardial infarction, are major cause of perioperative morbidity or
mortality, its true incidence is difficult to assess. The risk of
perioperative cardiac complications depends mainly on two conditions: 1)
identified risk factors, and 2) the type of the surgical procedure. On that
basis, different scoring systems have been developed in order to accurately
assess the perioperative cardiac risk and to improve the patient management.
Importantly, patients with estimated high risk should be tested
preoperatively by non-invasive cardiac imaging modalities. According to test
results, they can proceed directly to planed surgery with the use of
cardioprotective drugs (?-blockers, statins, aspirin), or to myocardial
revascularization prior to non-cardiac surgery. In this review, we discuss
the role of clinical cardiac risk factors, laboratory measurements,
additional non-invasive cardiac testing, and consequent strategies in
perioperative management of patients undergoing noncardiac surgery.
Publisher
National Library of Serbia