Assessing and Reducing Cardiovascular Risks Before Noncardiac Surgery: Best Practices

Patients undergoing noncardiac surgery often have underlying cardiovascular disease (CVD) or CVD risk factors, which can increase their risk for perioperative complications. To determine best practices for perioperative CV risk assessments — a common reason for cardiology consultation — these authors comprehensively reviewed clinical practice guidelines, meta-analyses, and randomized clinical trials. Highlights were as follows:

• The medical history and physical exam are the foundation: They can identify underlying risk factors and assess the patient's functional capacity. The inability to perform workloads under 4 metabolic equivalent tasks is associated with greater risk for perioperative CV complications.

• Predicting patient- and surgery-spec…