From guidelines to clinical practice: current recommendations for the management of cardiac patients undergoing non-cardiac surgery

Abstract

Non-cardiac surgeries account for nearly 85% of the to­tal 300 million surgeries that are performed annually world­wide, cardiovascular events representing the main source of perioperative morbidity and mortality. Considering that often patients suffering from cardiovascular (CV) di­sea­ses tend be clinically fragile, clear recommendations are needed to guide clinical decisions, in order to minimize their perioperative risk. The current ESC guideline main­tains some of the classic indications, emphasizing the im­por­tance of preoperative risk assessment and clinical exa­mi­na­tion of the patients suffering from a CV disease. It also introduces new concepts regarding the preoperative use of biomarkers, the perioperative thromboprophylaxis and the management of patients newly diagnosed with mur­murs, dyspnea, oedema or angina. Furthermore, other sec­tions, approaching complex clinical situations, as peri-ope­ra­tive management of antiplatelet and anti­coagulant the­ra­pies, have been revised, according to the latest studies. This review is meant to concisely present these new recom­men­da­tions, in a simplified and more accessible manner.