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Preoperative cardiac risk assessment
Preoperative risk assessment and postoperative monitoring flow diagram. If suspected undiagnosed severe obstructive intracardiac abnormality or severe PHTN a preoperative echocardiogram is recommended. If possible unstable cardiac condition (e.g., unstable angina) then risks and benefits of delaying, canceling, or proceeding with surgery need to be discussed with the patient. RCRI score (each worth 1 point): history of coronary artery disease, cerebrovascular disease, congestive heart failure, preoperative insulin use, preoperative creatinine > 177 micromoles/L, and high-risk surgery (i.e., intraperitoneal, intrathoracic, or suprainguinal vascular surgery). BNP, brain natriuretic peptide; ECG, electrocardiogram; NT-proBNP, N-terminal pro-brain natriuretic peptide; PACU, postanesthesia care unit; PHTN, pulmonary hypertension; RCRI, Revised Cardiac Risk Index.
Adapted from Duceppe E, et al. Can J Cardiol. 2017;33(1):17-32
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Preoperative cardiac risk assessment
Cardiac evaluation and care algorithm for non-cardiac surgery
Adapted from Fleisher LA, et al. J Am Coll Cardiol. 2014;64:e77-e137
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