Updated Guideline for Perioperative Cardiovascular Management of Patients Undergoing Noncardiac Surgery

Earlier this year, the American College of Cardiology/American Heart Association updated its guideline for perioperative management of cardiac conditions. In this ≈100-page document, the authors make recommendations about risk assessment, preoperative diagnostic testing, and many other topics relevant to clinicians who care for patients before or after surgery (NEJM JW Gen Med Nov 1 2024 and Circulation 2024; 150:e351).

As in prior guidelines, the authors propose a stepwise approach to preoperative cardiac risk assessment that begins with use of a validated risk calculator. In elevated-risk patients, the authors now suggest assessing functional capacity with the Duke Activity Status Index (DASI), which might predict adverse outcomes better t…