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Pre-operative Cardiac Risk Assessment and Perioperative Cardiac Management in Non-Cardiac Surgery

Topics: The Cardiac Consult


Regarding the situation of Professor Don Poldermans, previously Chairman of the Task Force for the “Guidelines for pre-operative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery”

Read the ESC statements:

Guidelines currently under revision. New version expected in summer 2014.

Our (ACC,AHA, ESC) current joint position is that the initiation of beta blockers in patients who will undergo non-cardiac surgery should not be considered routine, but should be considered carefully by each patient’s treating physician on a case-by-case basis. (From August statement)

- August 2013
March 2013

14/09/2009 00:00:00

Current versions available to download

Publication dateVersionsReferencesSize
 CorrigendumEHJ - doi:10.1093/eurheartj/ehp60663 KB
 Essential MessagesEssential Messages - Non-Cardiac Surgery827 KB
2009Full TextEuropean Heart Journal (2009) 30, 2769–2812; doi:10.1093/eurheartj/ehp337
 Pocket GuidelinesTable of Contents
 PdaElectronic versions for Pocket PC, Palm OS, Smartphone & iPhones
 CME QuestionsCME Questions - Perioperative Cardiac Care

Current translated versions available to download:


Don Poldermans FESC (Chairperson); Jeroen Bax FESC; Eric Boersma FESC; Stefan de Hert; Erik Eeckhout FESC; Gerry Fowkes; Bülent Görenek FESC; Michael G. Hennerici; Bernard Iung FESC; Malte Kelm FESC; Keld Per Kjeldsen; Steen Dalby Kristensen FESC; Jose Lopez-Sendon FESC; Paolo Pelosi; François Philippe; Luc Pierard FESC; Piotr Ponikowski FESC; Jean-Paul Schmid; Olav F. M. Sellevold; Rosa Sicari FESC; Greet Van Den Berghe; Frank Vermassen

Additional Contributors: Sanne Hoeks; Ilse Vanhorebeek


Declarations of Interest of the experts involved in the elaboration of the document.

Endorsed by:

Table of contents

Preamble and introduction

  • Magnitude of the problem
  • Impact of the ageing population
  • Purpose

Pre-operative evaluation

  • Surgical risk for cardiac events
  • Functional capacity
  • Risk indicessp
  • Biomarkers
  • Non-invasive testing
  • Angiography

Risk reduction strategies

  • Pharmacological
  • Revascularization

Specific diseases

  • Chronic heart failure
  • Arterial hypertension
  • Valvular heart disease
  • Arrhythmias
  • Renal disease
  • Cerebrovascular disease
  • Pulmonary disease

Perioperative monitoring

  • Electrocardiographyp
  • Transoesophageal echocardiography
  • Right heart catherization
  • Disturbed glucose metabolism


  • Intraoperative anaesthetic management
  • Neuraxial techniques
  • Post-operative pain management

Previous versions

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