Perioperative cardiac risk

Pathophysiology, assessment and management

Ramachandra Sista, Kavita V. Ernst, Euan A. Ashley

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Cardiac complications are the leading cause of perioperative morbidity and mortality following noncardiac surgery. The annual cost of perioperative cardiovascular events exceeds US$20 billion. A strategic preoperative evaluation holds the potential to reduce perioperative cardiac events and healthcare costs; however, our current understanding of the pathophysiological basis of postoperative acute coronary syndromes is limited. Although significant advances continue to facilitate early and reliable noninvasive, detection of high-risk coronary anatomy, the most appropriate interventions remain unclear. Pharmacotherapy, revascularization, safer anesthesia and early detection of perioperative heart failure may all reduce perioperative morbidity and mortality, although the evidence base is incomplete and controversial. A close working relationship between the primary care physician, cardiologist, surgeon and anesthesiologist will facilitate rational, tailored and optimized management decisions that constitute our best opportunity to reduce perioperative cardiovascular risk.

Original languageEnglish (US)
Pages (from-to)731-743
Number of pages13
JournalExpert Review of Cardiovascular Therapy
Volume4
Issue number5
DOIs
StatePublished - Sep 2006

Fingerprint

Risk Management
Morbidity
Mortality
Primary Care Physicians
Acute Coronary Syndrome
Health Care Costs
Anatomy
Anesthesia
Heart Failure
Costs and Cost Analysis
Drug Therapy
Surgeons
Anesthesiologists
Cardiologists

Keywords

  • β-blockers
  • Catecholamines
  • Coronary plaque
  • Dobutamine stress echo
  • Non-ST elevation myocardial infarction
  • Perioperative
  • Pulmonary artery catheterization
  • ST elevation myocardial infarction

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Perioperative cardiac risk : Pathophysiology, assessment and management. / Sista, Ramachandra; Ernst, Kavita V.; Ashley, Euan A.

In: Expert Review of Cardiovascular Therapy, Vol. 4, No. 5, 09.2006, p. 731-743.

Research output: Contribution to journalReview article

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