Cardiac evaluation and care algorithm for non-cardiac surgery.
ACC/AHA cardiac evaluation and care algorithm for non-cardiac surgery based on active clinical conditions, known cardiovascular disease, or cardiac risk factors for patients 50 years of age or greater. A stepwise approach to the risk assessment of patients with pre-existing cardiac disease, scheduled for surgery. Subsequent care may include cancellation or delay of surgery, coronary revascularization followed by non-cardiac surgery, or intensified care.
click the picture to enlarge:
*Unstable coronary syndromes, decompensated heart failure, significant arrhythmias, severe valvular disease.
†4 METs is roughly the activity equivalent of climbing a flight of stairs or walking on level ground at 4 miles per hour.
‡Clinical risk factors include history of ischemic heart disease, congestive heart failure, cerebrovascular disease, diabetes, and renal insufficiency.
§Consider peri-operative beta-blockade.
Vascular (reported cardiac risk often more than 5%)
• Aortic and other major vascular surgery
• Peripheral vascular surgery
Intermediate (reported cardiac risk generally 1–5%)
• Intraperitoneal and intrathoracic surgery
• Carotid endarterectomy
• Head and neck surgery
• Orthopedic surgery
• Prostate surgery
Low (reported cardiac risk generally less than 1%)
• Endoscopic procedures
• Superficial procedures
• Cataract surgery
• Breast surgery
• Ambulatory surgery
Read also:
