Preoperative evaluation for non-cardiac surgery

Internists are frequently consulted to perform preoperative risk assessments on patient undergoing noncardiac surgery. Physicians need to assess the cardiac risk associated with the surgery, identify the patient's unique risk profile, recommend appropriate preoperative testing and make suitable recommendations. By a focused history-taking, physical examination, and application of current evidence-based guidelines in cardiac risk assessments, patients at high risk for complications at surgery can be identified and additional work-up suggested. Effective preoperative recommendation includes an assessment of risk (cardiac and non-cardiac), recommendations on medication adjustment, thrombo-embolic prophylaxis, and use of perioperative β blockers. Prompt communication with the surgeon often enhances the quality of medical consultation and ensures compliance.