• D K Potyk.
• University of Washington School of Medicine, Spokane, USA. potykd@shmc.org
• Tex Med. 2000 Mar 1;96(3):58-66.

AbstractPrimary care physicians, surgeons, and anesthesiologists are all involved in assessing patients before surgery. The medical literature describes techniques to identify high-risk cardiac patients before elective surgery and strategies to reduce risk once these patients have been identified. Multifactorial indices can identify high-risk patients undergoing nonvascular surgery. Selective use of dipyridamole-thallium imaging based on clinical factors will identify high-risk patients before vascular surgery. Once high-risk patients have been identified, risk reduction can be attempted in various ways. We have no convincing evidence that prophylactic revascularization benefits high-risk patients. Perioperative beta-blockade reduces perioperative myocardial ischemia, mortality, and the incidence of cardiovascular complications for up to 2 years. Therefore, perioperative beta-blockers are recommended for high-risk patients undergoing elective noncardiac surgery.

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