Perioperative cardiovascular risk assessment and management for noncardiac surgery

Last reviewed: 17 Jul 2025
Last updated: 05 Aug 2025

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 noncardiac surgery
  • Diagnostic tests
  • Cardiac risk stratification using stress testing
  • Perioperative therapy
  • Postoperative surveillance
  • Special circumstances
  • Guidelines
Full details

Contributors

Authors

Debabrata Mukherjee, MD, FACC
Debabrata Mukherjee

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.

References

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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

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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