Abstract
The decision to order preoperative laboratory tests for the obese patient with known cardiovascular disability must be predicated on the assumption that the results of testing will generate a change in anesthetic technique, type and extent of perioperative cardiovascular monitoring and possibly prompt therapeutic interventions before the intended surgical procedure. The single most important criterion for testing is that the results should contribute to improved perioperative cardiovascular outcome. The common practice of “routine testing”, based on excessive BMI, should be avoided.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Lavie CJ, Milani RV, Ventura HO (2009) Obesity and cardiovascular disease. Risk factor, paradox, and impact of weight loss. J Am Coll Cardiol 53:1925–1932
Wozniak SE, Gee LL, Wachtel MS et al (2009) Adipose tissue: the new endocrine organ? A review article. Dig Dis Sci 54:1847–1856
Hajer GR, van Haeften TW, Visseren FL (2008) Adipose dysfunction in obesity, diabetes, and vascular diseases. Eur Heart J 29:2959–2971
Harmancey R, Wilson CR, Taegtmeyer H (2008) Adaptation and maladaptation of the heart in obesity. Hyperten 52:181–187
Abel ED, Litwin SE, Sweeney G (2008) Cardiac remodeling in obesity. Physiol Rev 88:389–419
Alpert MA (2001) Obesity cardiomyopathy: pathophysiology and evolution of the clinical syndrome. Am J Med Sci 321:225–236
Poirier P, Giles TD, Bray GA et al (2006) Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss: an update of the 1997 American Heart Association scientific statement on obesity and heart disease from the obesity committee of the council of nutrition, physical activity, and metabolism. Circ 113:898–918
Fraley MA, Birchem JA, Senkottaiyan N et al (2005) Obesity and the electrocardiogram. Obes Rev 6:275–281
Darbar D, Kimbrough J, Jawaid A et al (2008) Persistent atrial fibrillation is associated with reduced risk of torsades de pointes in patients with drug-induced long QT syndrome. J Am Coll Cardiol 51:836–842
Poirier P, Alpert MA, Fleisher LA et al (2009) Cardiovascular evaluation and management of severely obese patients undergoing surgery: a science advisory from the American Heart Association. Circ 120:86–95
Deswal A, Bozkurt B (2008) Treatment of patients with heart failure and preserved ejection fraction. Curr Treat Options Cardiovasc Med 10:516–528
Cohn SL (2006) Cardiac risk stratification before noncardiac surgery. Cleve Clin J Med 73(Suppl 1):S18–S24
Larsson UE, Reynisdottir S (2008) The six minute walk test in outpatients with obesity: reproducibility and known group validity. Physiother Res Int 13:84–93
Hulens M, Vansant G, Claessens AL et al (2003) Predictors of 6-minute walk test results in lean, obese, and morbidly obese women. Scand J Med Sci Sports 13:89–105
Priebe H-J (2011) Preoperative cardiac management of the patient for non-cardiac surgery: an individualized and evidence-based approach. Br J Anaesth 107:83–96
Glance LG, Wissler R, Mukamel DB et al (2010) Perioperative outcomes among patients with the modified metabolic syndrome who are undergoing noncardiac surgery. Anesthesiol 113:859–872
Gami AS, Witt BJ, Howard DE et al (2007) Metabolic syndrome and risk of cardiovascular events and death. J Am Coll Cardiol 49:403–414
Lee TH, Marcantonio ER, Mangione CM et al (1999) Derivation and prospective validation of a simple index for prediction of cardiac risk. Circ 100:1043–1049
Eagle KA, Berger PB, Calkins H et al (2002) ACC/AHA guideline update for perioperative cardiovascular evaluation for non-cardiac surgery-executive summary. J Am Coll Cardiol 39:542–553
Poldermans D, Bax J, Boersma E et al (2009) Guidelines for pre-operative cardiac risk assessment and peri-operative cardiac management in non-cardiac surgery: the task force for pre-operative risk assessment and peri-operative cardiac management in non-cardiac surgery of the European society of cardiology (ESC) and endorsed by the European society of anaesthesiology. Eur Heart J 30:2769–2812
Naylor AR, Mehta Z, Rothwell PM et al (2011) Reprinted article carotid artery disease and stroke during coronary artery bypass: a critical review of the literature. Eur J Vasc Endovasc Surg 42(Suppl 1):S73–S83
Abbaszadeh M (2011) The impact of carotid artery disease on outcomes of patients undergoing coronary artery bypass grafting. Rev Bras Cir Cardiovasc 26:258–263
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer-Verlag Italia
About this chapter
Cite this chapter
Bernstein, D.P. (2013). Is a Full Cardiac Workup Indicated for Morbidly Obese Patients with Cardiac Disease?. In: Leykin, Y., Brodsky, J. (eds) Controversies in the Anesthetic Management of the Obese Surgical Patient. Springer, Milano. https://doi.org/10.1007/978-88-470-2634-6_6
Download citation
DOI: https://doi.org/10.1007/978-88-470-2634-6_6
Published:
Publisher Name: Springer, Milano
Print ISBN: 978-88-470-2633-9
Online ISBN: 978-88-470-2634-6
eBook Packages: MedicineMedicine (R0)