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In the course of a month you are asked to see three patients preoperatively for surgical clearance. The following three cases are probably representative of patients you see on a daily basis in the office.

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References

  1. Eagle KA, Brundage BH, Chaitman BR, et al. Guidelines for perioperative cardiovascular evaluation for noncardiac surgery. Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Committee on Perioperative Cardiovascular Evaluation for Noncardiac Surgery. Circulation 1996;93:1278–1317.

    PubMed  CAS  Google Scholar 

  2. Eagle KA, Berger P, Calkins H, et al. ACC/AHA guidelines update for perioperative cardiovascular evaluation for noncardiac surgery – executive summary. J Am Coll Cardiol 2002;39:542–53.

    Article  PubMed  Google Scholar 

  3. Fleisher LA, Beckman JA, Brown KA, et al. ACC/AHA 2007 Guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: executive summary. J Am Coll Cardiol 2007; 50: 1707–25.

    Article  PubMed  Google Scholar 

  4. Macpherson DS, Lefgren RP. Outpatient internal medicine preoperative evaluation: a randomized clinical trial. Med Care 1994;32:498–507.

    Article  PubMed  CAS  Google Scholar 

  5. Goldman L, Caldera D, Nussbaum S, et al. Multifactorial index of cardiac risk in noncardiac surgical procedures. N Engl J Med 1977;297:845–50.

    PubMed  CAS  Google Scholar 

  6. Mahar LJ, Steen PA, Tinker JA, et al. Perioperative myocardial infarction in patients with coronary artery disease with and without aorta-coronary bypass grafts. J Thorac Cardiovasc Surg 1978;76:533–7.

    PubMed  CAS  Google Scholar 

  7. DiCarli, MF, Hochamovitch R. Should we screen for occult coronary disease among asymptomatic patients with diabetes? J Am Coll Cardiol 2005;45:50–53.

    Article  Google Scholar 

  8. Anand DV, Lim A, Lahiri A, et al. The role of non-invasive imaging in the risk stratification of asymptomatic diabetic patients. Eur Heart J 2006;27(8):905–12.

    Article  PubMed  Google Scholar 

  9. Scognamiglio R, Negut C, Ramondo A, et al. Detection of coronary artery disease in asymptomatic patients with Type 2 Diabetes Mellitus. J Am Coll Cardiol 2006;47(1):65–71.

    Article  PubMed  Google Scholar 

  10. Giri S, Shaw LJ, Murthy DR, et al. Impact of diabetes on the risk stratification using stress single-photon emission computed tomography myocardial perfusion imaging in patients suggestive of coronary artery disease. Circulation 2002;105:32.

    Article  PubMed  Google Scholar 

  11. Bax Ro, Bonow D, Tschope SE, et al. The potential of myocardial perfusion scintigraphy for risk stratification of asymptomatic patients with Type 2 Diabetes. J Am Coll Cardiol 2006;48(4):754–60.

    Article  Google Scholar 

  12. Kumar R, McKinney WP, Raj G, et al. Adverse cardiac events after surgery: assessing risk in a veteran population. J Gen Intern Med 2001;16:507.

    Article  PubMed  CAS  Google Scholar 

  13. Auerbach A, Goldman L. Assessing and reducing the cardiac risk of noncardiac surgery. Circulation 2006;113:1361.

    Article  PubMed  Google Scholar 

  14. Mangano DT, Goldman L. Preoperative assessment of patients with known or suspected coronary disease. N Engl J Med 1995;333:1750.

    Article  PubMed  CAS  Google Scholar 

  15. Best PJ, Tajik AJ, Gibbons RJ, et al. The safety of treadmill exercise stress testing in patients with abdominal aortic aneurysms. Am Intern Med 1998;129:628.

    CAS  Google Scholar 

  16. Etchells E, Meade M, Tomilinson G, et al. Semiquantitative dipyridamole myocardial stress perfusion imaging for cardiac risk assessment before noncardiac vascular surgery: a meta-analysis. J Vasc Surg 2002;36:534.

    Article  PubMed  Google Scholar 

  17. Lette J, Waters D, Cerino M, et al. Preoperative coronary artery disease risk stratification based on dipyridamole imaging and a simple three-step, three-segment model for patients undergoing noncardiac vascular surgery or major general surgery. Am J Cardiol 1992;69:1553.

    Article  PubMed  CAS  Google Scholar 

  18. Jeger R, Probst C, Arsiner R. Long-term prognostic value of preoperative 12-lead electrocardiogram before major noncardiac surgery in coronary artery disease. Am J Cardiol 2006;151(2):1508–13.

    Google Scholar 

  19. Devereaux PJ, Goldman L, Yusef S, et al. Surveillance and prevention of major perioperative ischemic cardiac events in patients undergoing noncardiac surgery: a review. CAMJ 2005;173:779.

    CAS  Google Scholar 

  20. Kaluza GL, Joseph J, Lee JR, et al. Catastrophic outcomes of noncardiac surgery soon after coronary stenting. J Am Coll Cardiol 2002;35:1288–94.

    Article  Google Scholar 

  21. Wilson SH, Fasseas P, Orford JL, et al. Clinical outcome of patients undergoing noncardiac surgery in the two months following coronary stenting. J Am Coll Cardiol 2003;42:234–40.

    Article  PubMed  Google Scholar 

  22. Leibowitz D, Cohen M, Planer D, et al. Comparison of cardiovascular risk of noncardiac surgery following coronary angioplasty with versus without stenting. Am J Cardiol 2006;97:1188–91.

    Article  PubMed  Google Scholar 

  23. McFall EO, Ward HB, Moritz TF, et al. Coronary artery revascularization before elective major vascular surgery. N Engl J Med 2004;351:2795–2804.

    Article  Google Scholar 

  24. Fleisher LA, Beckman JA, Brown KA, et al. ACC/AHA Guidelines update on perioperative cardiovascular evaluation for noncardiac surgery: focused update on perioperative beta-blocker therapy. J Am Coll Cardiol 2006;47:2343–55.

    Article  PubMed  Google Scholar 

  25. Lindenauer PK, Pekow P, Wang K, et al. Perioperative beta-blocker therapy and mortality after major noncardiac surgery. N Engl J Med;353:349–61.

    Google Scholar 

  26. Poldermans D, Boersma F, Bax JJ, et al. The effect of bisoprolol on perioperative mortality or myocardial infarction in high-risk patients undergoing vascular surgery. N Engl J Med 1999;341:1789–94.

    Article  PubMed  CAS  Google Scholar 

  27. Devereaux PJ, Beattie WS, Choi PT, et al. How strong is the evidence for use of perioperative beta-blockers in non-cardiac surgery? Systematic review and meta-analysis of randomized controlled trials. BMJ 2005;313–21.

    Google Scholar 

  28. Pasternack PF, Grossi EA, Baumann FG, et al. Beta-blocker to decrease silent myocardialischemia during peripheral vascular surgery. Am J Surg 1989;158:113–6.

    Google Scholar 

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Jack Pyhel, H. (2009). Exercise Testing as Applied to the Preoperative Patient. In: Evans, C.H., White, R.D. (eds) Exercise Stress Testing for Primary Care and Sports Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-76597-6_10

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  • DOI: https://doi.org/10.1007/978-0-387-76597-6_10

  • Publisher Name: Springer, New York, NY

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