Pre-Operative Cardiovascular Assessment
- Mondays 9am to 11am
- Thursdays 3pm to 5 pm
Please call 404-298-2220 for appointments or more urgent request
An estimated 33 million patients undergo surgery in the United States yearly. Serious adverse events occur in more than 1 million of these patients at an estimated cost of $25 billion annually. With the aging population, it is anticipated that surgical referrals will increase by 25%, costs by 50%, and costs of preoperative complications by 100%. Given these staggering numbers, it is imperative that clinicians involved with patients undergoing surgery provide the proper risk assessment and stratification.
Cardiovascular complications are one of the most common preoperative adverse events in patients undergoing noncardiac surgery. Although in absolute numbers they are rare, they are associated with a mortality rate as high as 70%. Over the years, the guidelines for the evaluation of these patients have changed but not the associated risks or medical liability to physicians.
The Core Goals of the Preoperative Cardiac Clinic Are to:
- Determine the status of a suspected or known cardiovascular condition
- Provide an estimate of cardiovascular risk based on established ACC guidelines and professional judgment
- Determine if further testing is warranted
- Determine if interventions are warranted (medical or procedural) to reduce perioperative cardiac risk
- Facilitate safe and timely surgical intervention by allotting designated times for evaluations
- Decrease post operative hospital stays by addressing cardiac issues and medications preoperatively
Who Should Be Referred for Evaluation?
- Known cardiovascular disease without established cardiology relationship
- Suspected cardiovascular disease from history and physical examination
- Abnormal ECG demonstrating Q waves, ST changes, primary T wave changes, LBBB or any new findings
- High Risk Co morbidities: diabetes mellitus, chronic kidney disease, peripheral artery disease, stroke, rheumatoid arthritis, lupus, etc….
- Advanced age with limited functional capacity <4 METS)
- Multiple cardiac risk factors and high risk surgery
- Complex cardiovascular medications (anticoagulants, antiplatelets) or implanted devices