CASE HISTORY – May 2008

Cardiac patient for noncardiac surgery

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Abstract

The population of Estonia is ageing. In 2007 31% of surgical patients treated in Tartu University Hospital were aged 65 years and older. Usually elderly patients have cardiovascular problems, they use regularly various medications and have high perioperative risk. It is recommended to evaluate cardiac risk for surgery using a revised cardiac risk index (RCRI) based on the history and clinical signs of cardiovascular function. For evaluation the total risk of surgery, the ASA (American Society of Anesthesiologists) classification is used. To minimize perioperative risk, to improve outcome and ro reduce mortality, careful preoperative evaluation of the cardiac patient for noncardiac surgery is extremely important. The team consisting of a general practitioner, a surgeon, an anaesthesiologist and a cardiologist should evaluate the risk of surgery on the basis of the clinical status of the patient in order to make preoperative treatment decisions and to evaluate optimal time for surgery.