Preoperative cardiac risk assessment prior to noncardiac surgery

Cardiac complications remain an important cause of perioperative morbidity and mortality with noncardiac surgery, despite improvement in surgical techniques and anaesthetic management. Therefore preoperative cardiovascular risk assessment plays a pivotal role in management of patients prior to noncardiac surgery. Thorough history-taking and careful examination are essential to consider further diagnostic steps in order to predict the patient's individual perioperative cardiac risk as accurately as possible. Besides elaboration of medical therapy, cardiac catherization and even balloon angioplasty or bypass surgery must be considered if indicated by preoperative cardiac testing.