Preoperative Cardiovascular Risk Assessment in New York
Approximately 27 million patients undergo non-cardiac surgery every year in the United States. Of those patients, about 50,000 have a perioperative myocardial infarction (MI), and over half of the 40,000 perioperative deaths each year are caused by cardiac events. Considering that this patient population will significantly increase over the years, the number of patients with significant perioperative cardiac risk can be expected to increase worldwide.
Most perioperative cardiac morbidity and mortality is related to MI, heart failure, or arrhythmias. This includes patients with known or suspected coronary artery disease (CAD), arrhythmias, history of heart failure, or symptoms consistent with these conditions. Therefore, preoperative cardiovascular risk assessment and perioperative management emphasize the detection, characterization, and treatment of CAD, left ventricular systolic dysfunction, and significant arrhythmias in patients.
Purpose and Goals of Risk Assessment Near NYC
Risk assessments evaluate the potential risks that may be involved in a procedure and determine the likelihood that a specified negative event will occur. There are two purposes of the preoperative cardiac risk assessment. One is to assess the medical status of the patient and the cardiac risks that can occur during and after the specific type of non-cardiac surgery performed.
Patients over the age of 65 are at a higher risk of cardiac disease, cardiac morbidity, and death. Therefore, it’s important to perform a full physical examination and cardiac risk assessment. The history and physical examination are critical in helping to identify indicators of cardiac risk and in assessing the patient’s cardiac status.
The second purpose of the risk assessment is to recommend appropriate strategies to reduce the risk of cardiac problems over the entire perioperative period, and to improve long-term cardiac outcomes.
The main goals of the assessment are to identify patients who are at an increased risk of a perioperative cardiac event and to evaluate a patient’s perioperative prognosis related to cardiovascular disease. The type of surgery has important implications for perioperative risk. Non-cardiac surgery can be placed into high-risk, intermediate-risk, and low-risk categories. Even though the risk at the time of non-cardiac surgery may not be severe, appropriate treatment can affect long-term prognosis.
The assessment should be individualized to the patient and the specific clinical setting. Patients that are undergoing emergent surgery will only be able to receive a quick preoperative assessment, with management directed at preventing or minimizing cardiac morbidity and mortality. After surgery, these patients can then undergo more thorough evaluations. On the other hand, patients undergoing elective procedures can undergo a more thorough preoperative evaluation.
Heart disease is the leading cause of death in the United States. That is why a preoperative cardiovascular risk assessment can be vital for patients undergoing non-cardiac surgery. At Preventive Cardiology of New York, we provide risk assessments as part of our Consultative Cardiology Services. Contact us today for more information!