American College of Cardiology

EAGLE ET AL., PERIOPERATIVE CARDIOVASCULAR EVALUATION FOR NONCARDIAC SURGERY UPDATE
http://www.acc.org/clinical/guidelines/perio/update/periupdate_index.htm

ACC/AHA Guideline Update for Perioperative Cardiovascular Evaluation for Noncardiac Surgery

A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1996 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery)

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New Table 5a. Shortcut to Noninvasive Testing in Preoperative Patients if Any Two Factors Are Present

1. Intermediate clinical predictors are present (Canadian class 1 or 2 angina, prior MI based on history or pathologic Q waves, compensated or prior heart failure, diabetes, or renal insufficiency)
2. Poor functional capacity (less than 4 METs)
3. High surgical risk procedure (emergency major operations*; aortic repair or peripheral vascular surgery; prolonged surgical procedures with large fluid shifts or blood loss)

MI indicates myocardial infarction; HF, heart failure; METs, metabolic equivalents.

Modified with permission from: Leppo JA, Dahlberg ST. The question: to test or not to test in preoperative cardiac risk evaluation. J Nucl Cardiol. 1998;5:332-42.

Copyright © 1998 by the American Society of Nuclear Cardiology. This material may not be reproduced, stored in a retrieval system, or transmitted in any form or by any means without the prior permission of the publisher.

*Emergency major operations may require immediately proceeding to surgery without sufficient time for noninvasive testing or preoperative interventions.