Skip to main content

Preoperative Cardiac Evaluation

  • Conference paper
  • 103 Accesses

Part of the book series: Topics in Anaesthesia and Critical Care ((TIACC))

Abstract

Cardiac disease is a significant problem in developed nations. In the United States, an estimated 17 million people have cardiac disease [1]. Two thirds have coronary artery disease (CAD), and 3 million undergo surgery each year. The incidence of perioperative myocardial infarction (MI) is about 6% in those with prior MI, and 3%–20% in those with significant CAD having major vascular surgery. Overall mortality is 25%–75%. Up to 150,000 patients each year may therefore sustain perioperative MI, leading to more than 50,000 deaths. Regardless of clinical outcome, patients with perioperative MI incur $10,000–20,000 in extra hospital costs compared to those without MI [2].

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   34.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Mangano DT (1999) Preoperative assessment of cardiac risk. In: Kaplan JA (ed) Cardiac Anesthesia. Saunders, Philadelphia, pp 3–39

    Google Scholar 

  2. Kalish RR, Daley J, Duncan CC et al (1995) Costs of potential complications of care for major surgery patients. Am J Med Quality 10: 48–54

    Article  CAS  Google Scholar 

  3. Eagle KA, Brundage BR et al (1996) Guidelines for perioperative cardiac evaluation for noncardiac surgery. Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Committee on Perioperative Cardiovascular Evaluation for noncardic surgery. Circulation 93: 1278: 1317

    Google Scholar 

  4. Rao TK, Jacobs KA,El-Etr AA (1983) Reinfarction following anesthesia in patients with myocardial infarction. Anesthesiology 59: 499–505

    CAS  Google Scholar 

  5. Mangano DT, Browner WS, Hollenberg M et al (1990) Association of perioperative myocardial ischemia with cardiac morbidity and mortality in men undergoing noncardiac surgery. The Study of Perioperative Ischemia Research Group. N Engl J Med 323: 1781–1788

    Google Scholar 

  6. Mangano DT, Browner WS, Hollenberg M et al (1992) Long-term cardiac prognosis following noncardiac surgery: the study of perioperative ischemia research group. JAMA 268: 233–239

    Article  PubMed  CAS  Google Scholar 

  7. Yeager RA, Moneta GL, Edwards JM et al (1994) Late survival after perioperative myocardial infarction complicating vascular surgery. J Vasc Surg 20: 598–606

    Article  PubMed  CAS  Google Scholar 

  8. Gunnar RM, Passamani ER, Bourdillon PD et al (1990) Guidelines for the early management of patients with acute myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic cardiovascular Procedures ( Subcommittee to Develop Guidelines for the Early management of Patients with Acute Myocardial Infarction ). J Am Coll Cardiol 16: 249–292

    Google Scholar 

  9. Goldman L, Caldera DL, Nussbaum SR et al (1987) Multifactorial index of cardiac risk in noncardiac surgical procedures: ten-year status report. J Cardiothorac Anesth 1: 237–244

    Article  PubMed  CAS  Google Scholar 

  10. Goldman L, Caldera DL, Nussbaum SR et al (1977) Multifactorial index of cardiac risk in noncardiac surgical procedures. N Engl J Med 297: 845–850

    Article  PubMed  CAS  Google Scholar 

  11. Detsky AS, Abrams HB, McLaughlin JR et al (1986) Predicting cardiac complications in patients undergoing noncardiac surgery. J Gen Intern Med 1: 211–219

    Article  PubMed  CAS  Google Scholar 

  12. Cooperman M, Pflug B, Martin EW Jr, Evans WE (1978) Cardiovascular risk factors in patients with peripheral vascular disease. Surgery 84: 505–509

    PubMed  CAS  Google Scholar 

  13. Pasternack, PF, Imparato AM, Riles TS et al (1985) The value of the radionuclide angiogram in the prediction of perioperative myocardial infarction in patients undergoing lower extremity revascularization procedures. Circulation 72: 1113–1117

    Google Scholar 

  14. Hollenberg M, Mangano DT, Browner WS et al (1992) Predictors of postoperative myocardial ischemia in patients undergoing noncardiac surgery: the Study of Perioperative Ischemia Research Group. JAMA 268: 205–209

    Article  PubMed  CAS  Google Scholar 

  15. O’Kelly B, Browner WS, Massie B et al (1992) Ventricular arrhythmias in patients undergoing noncardiac surgery: the Study of Perioperative Ischemia Research Group. JAMA 286: 217–221

    Google Scholar 

  16. Atlee JL (1997) Management of perioperative dysrhythmias. Anesthesiology 86: 1397–1424

    Article  PubMed  CAS  Google Scholar 

  17. Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNCV) (1993) Fifth report. Arch Intern Med 153: 154–183

    Google Scholar 

  18. Stone JG, Foex P, Sear JW (1988) Risk of myocardial ischaemia during anaesthesia in treated and untreated hypertensive patients. Br J Anaesth 61: 675–679

    Article  PubMed  CAS  Google Scholar 

  19. Charlson ME, MacKenzie CR, Gold JP et al (1990) Preoperative characteristics predicting intraoperative hypotension and hypertension among hypertensives and diabetics undergoing noncardiac surgery. Ann Surg 211: 66–81

    Article  Google Scholar 

  20. Stone JG, Foex P, Sear JW et al (1988) Myocardial ischemia in untreated hypertensive patients: effect of a single small oral dose of a beta-blocking agent. Anesthesiology 68: 495–500

    Article  PubMed  CAS  Google Scholar 

  21. Nelson AH, Fleisher LA, Rosenbaum SH (1993). Relationship between postoperative anemia and cardiac morbidity in high-risk vascular patients in the intensive care unit. Crit Care Med 21: 860–866

    Article  PubMed  CAS  Google Scholar 

  22. Kannel WB, McGee DL (1979) Diabetes and cardiovascular risk factors: the Framingham Study. Circulation 59: 8–13

    Article  PubMed  CAS  Google Scholar 

  23. Boucher CA, Brewster DC, Darling CR et al (1985) Determination of cardiac risk by dipyridamole-thallium imaging before peripheral vascular surgery. N Engl ‘J Med 312: 389–394

    Article  PubMed  CAS  Google Scholar 

  24. Cutler BS, Wheeler HB, Paraskos JA et al (1979) Assessment of operative risk with electrocardiographic exercise testing in patients with peripheral vascular disease. Am J Surg 137: 484–490

    Article  PubMed  CAS  Google Scholar 

  25. Pasternack, PF, Imparato AM, Bear G (1984) The value of the radionuclide angiography as a predictor of perioperative myocardial infarction in patients undergoing abdominal aortic aneurysm resection. J Vasc Surg 1: 320–325

    PubMed  CAS  Google Scholar 

  26. Carliner NH, Fisher ML, Plotnick GD et al (1985) Routine preoperative exercise stress testing in patients undergoing major noncardiac surgery. Am J Cardiol 56: 51–58

    Article  PubMed  CAS  Google Scholar 

  27. Chaitman BR (1986) The changing role of the exercise electrocardiogram as a diagnostic and prognostic test for chronic ischemic heart disease. Am J Cardiol 8: 1195–1210

    Article  CAS  Google Scholar 

  28. Gianrossi R, Detrano R, Mulvihill D et al (1989) Exercise-induced ST depression in the diagnosis of coronary artery disease: a meta-analysis. Circulation 80: 87–98

    Article  PubMed  CAS  Google Scholar 

  29. Detrano R, Gianrossi R, Mulvihill D et al (1989) Exercise-induced ST segment depression in the diagnosis of multivessel coronary disease: a meta-analysis. J Am Coll Cardiol 14: 1501–1508

    Article  PubMed  CAS  Google Scholar 

  30. Fleisher LA, Rosenbaum SH, Nelson AH et al (1995). Preoperative dipyridamole thallium imaging and Holter monitoring as a predictor of perioperative cardiac events and long term outcome. Anesthesiology 83: 906–917

    Article  PubMed  CAS  Google Scholar 

  31. Campeau L (1976) Grading of angina pectoris. Circulation 54: 522–523

    PubMed  CAS  Google Scholar 

  32. Hlatky MA, Boineau RE, Higginbotham MB et al (1989) A brief self-administered questionnaire to determine functional capacity (the Duke Activity Status Index). Am J Cardiol 64: 651–654

    Article  PubMed  CAS  Google Scholar 

  33. Fletcher GF, Balady G, Froelicher VF et al (1995) Exercise standards: a statement for healthcare professionals from the American Heart Association: Writing Group. Circulation 91: 580–615

    Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2001 Springer-Verlag Italia

About this paper

Cite this paper

Atlee, J.L. (2001). Preoperative Cardiac Evaluation. In: Atlee, J.L., Vincent, JL. (eds) Critical Care Cardiology in the Perioperative Period. Topics in Anaesthesia and Critical Care. Springer, Milano. https://doi.org/10.1007/978-88-470-2955-2_1

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-2955-2_1

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0133-6

  • Online ISBN: 978-88-470-2955-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics