Summary
Details
- Stepwise management approach
- History and physical examination
- Functional capacity assessment
- Cardiac risk stratification using clinical predictors and risk models
- Risk stratification according to type of non-cardiac surgery
- Diagnostic tests
- Cardiac risk stratification using stress testing
- Perioperative therapy
- Postoperative surveillance
- Special circumstances
- Guidelines
Contributors
Authors
Debabrata Mukherjee, MD, FACC

Chairman
Department of Internal Medicine
Professor of Internal Medicine
Texas Tech University Health Sciences Center
El Paso
TX
Disclosures
DM declares that he has no competing interests.
Peer reviewers
Martin Bocks, MD
Clinical Lecturer
University of Michigan Congenital Heart Center
Ann Arbor
MI
Disclosures
MB declares that he has no competing interests.
Andrew Turley, MB ChB
Cardiology Specialist Registrar
The James Cook University Hospital
Middlesbrough
UK
Disclosures
AT declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Thompson A, Fleischmann KE, Smilowitz NR, et al. 2024 AHA/ACC/ACS/ASNC/HRS/SCA/SCCT/SCMR/SVM guideline for perioperative cardiovascular management for noncardiac surgery: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. Circulation. 2024 Nov 5;150(19):e351-442.Full text Abstract
Halvorsen S, Mehilli J, Cassese S, et al. 2022 ESC guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery. Eur Heart J. 2022 Oct 14;43(39):3826-924.Full text Abstract
Duceppe E, Parlow J, MacDonald P, et al. Canadian Cardiovascular Society guidelines on perioperative cardiac risk assessment and management for patients who undergo noncardiac surgery. Can J Cardiol. 2017 Jan;33(1):17-32.Full text Abstract
Kristensen SD, Knuuti J, Saraste A, et al. 2014 ESC/ESA guidelines on non-cardiac surgery: cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA). Eur Heart J. 2014;35:2383-431.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Patient information
Heart attack: what is it?
Heart attack: questions to ask your doctor
More Patient informationLog in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer