Pocket Guidelines on Non-Cardiac Surgery: Cardiovascular Assessment and Management

Publication Date: 2022

Chairperson: Sigrun Halvorsen and Julinda Mehilli

Table of Contents

1. Introduction

2. Clinical risk evaluation

2.1. Surgery-related risk

2.2. Patient-related risk

2.3. Initial assessment

2.4. Patients with murmurs, chest pain, dyspnoea, or peripheral oedema

2.5. The patient perspective

3. Pre-operative assessment tools

3.1. Risk scores

3.2. Frailty and functional capacity

3.3. Electrocardiography

3.4. Biomarkers

3.5. Transthoracic echocardiography

3.6. Stress imaging

3.7. Angiography

4. General risk-reduction strategies

4.1. CV risk factors and lifestyle interventions

4.2. Pharmacological

4.3. Peri-operative handling of antithrombotic agents

Antiplatelets

Oral anticoagulants

4.4. Thromboprophylaxis

4.5. Patient blood management

Pre-operative anaemia—diagnosis and treatment

5. Specific diseases

5.1. Coronary artery diseases

5.2. Chronic heart failure

5.3. Valvular heart disease

5.4. Arrhythmias

5.5. Patients with cardiac implantable electronic devices (CIED)

5.6. Adult congenital heart disease

5.7. Pulmonary arterial hypertension

5.8. Arterial hypertension

5.9. Peripheral artery disease

5.10. Cerebrovascular disease

5.11. Renal disease

5.12. Obesity

5.13. Diabetes

5.14. Cancer

6. Peri-operative monitoring and anaesthesia

7. Peri-operative cardiovascular complications

7.1. Peri-operative myocardial infarction/injury

7.2. Atrial fibrillation

7.3. Peri-operative stroke

8. Central illustration