Perioperative cardiac risk assessment

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Why bother • The volume of non-cardiac surgery has progressively increased. • As IHD is common, cardiac complications are a major cause of perioperative morbidity and mortality. • Of the 27 million patients undergoing anesthesia annually, 50 000 suffer a perioperative myocardial infarction.
• Its imperative that, opinions regarding the operative risk and advice on perioperative management should also, • extend to treatment that will affect long-term patient outcomes
Page 1 and 2: Perioperative cardiac risk assessme
Page 3: Mrs X • The surgical ward sends i
Page 7 and 8: Methods for Assessing Risk Pre-Oper
Page 9 and 10: Why is Surgery Risky • The Anaest
Page 11 and 12: Inhalational agents • Halothane &
Page 13 and 14: When is there an increased risk of
Page 15 and 16: In patients with Coronary disease:
Page 17 and 18: Scoring systems Goldman Index • A
Page 19 and 20: Acute coronary syndromes • Acute
Page 21 and 22: Severe valvular disease • Severe
Page 23 and 24: Functional Capacity • Functional
Page 25 and 26: Step 1 • Determine the urgency of
Page 27 and 28: Highest Risk • Major emergency su
Page 29 and 30: Step 3 • Low risk surgery • In
Page 32 and 33: What do we know about Ms X now •
Page 34 and 35: What Risk does this demonstrate Cla
Page 36 and 37: Preoperative tests
Page 38 and 39: Evaluation of LV Function CLASS IIa
Page 41: Noninvasive stress testing Class I
Page 44 and 45: You organize a dobutamine stress ec
Page 46 and 47: Effect of Prior CABG on Cardiac Ris
Page 48 and 49: DECREASE V 101 pts with extensive i
Page 50 and 51: Why the controversy • Pathophysio
Page 52 and 53: • When revascularization is indic
Page 55:
STENTS If upcoming Sx is known then
Page 58 and 59:
Summary of PCI • Elective noncard
Page 60 and 61:
So Can we Just give her Drugs • R
Page 62 and 63:
POISE Trial • 8351 patients under
Page 64 and 65:
POISE Outcomes • Bla
Page 66 and 67:
Why this difference • Evidence to
Page 68 and 69:
Type of Beta Blocker May matter •
Page 71 and 72:
Statins
Page 73 and 74:
Statins Improve Long-Term Survival
Page 75 and 76:
Recommendations • Class 1a to con
Page 77:
Guidelines • The lack of specific
Page 80 and 81:
Recommendations • Alpha 2 agonist
Page 82 and 83:
The Effect of Percutaneous Revascul
Page 84 and 85:
Antibiotic Prophylaxis • Prosthet
Page 86 and 87:
Surveillance for Perioperative Myoc
Page 88:
Take Home Messages • Unstable syn
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Perioperative cardiac risk assessment

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