Pre-operative assessment of the patient with cardiac disease

Summary

Perioperative cardiac morbidity remains a significant problem throughout the world. Its solution requires identification of the at-risk patient to assess monitoring and therapeutic requirements throughout the perioperative period. Assessment of patients with cardiac disease is particularly challenging for several reasons. First, patients can present with a myriad of symptom complexes with varying degrees of clinical and subclinical ventricular dysfunction. And, secondly, we are in the age of cost-containment. There is increasing pressure on the anaesthesiologist to expedite the preoperative assessment given the rising population of come-and-go and come-and-stay surgery. In addition, the number and kind of preoperative cardiac tests will be limited. Thus, today, more than ever, the anaesthesiologist must have a thorough understanding of the types of preoperative cardiac tests available, the information they provide, and the indications for their use.

This chapter represents a source of information regarding the routine and non-routine preoperative tests available to anaesthesiologists, and will hopefully allow rational use of these important preoperative tests.