How to Reduce the Cardiac Risk, One of the Most Common Perioperative Complications Following Invasive Surgery in Gynecology

Abstract

The role of preoperative cardiac evaluation is to determine the medical condition of the patient's cardiovascular status .A history and cardiovascular examination are crucial to identify severe cardiac conditions such as unstable coronary syndromes, serious arrhythmias, decompensated HF, and valvular disease. These conditions would place the patient in a high surgical risk category. In some situations, an additional diagnostic cardiac evaluation is necessary on the basis of the results of the initial preoperative test. In an acute surgical emergency, preoperative evaluation might have to be limited to simple tests, such as a rapid assessment of cardiovascular vital signs, ECG, blood pressure, hematocrit, electrolytes, renal function, blood analysis. Only the most essential tests and interventions are appropriate until the acute surgical emergency is resolved. Under other, less urgent circumstances, the preoperative cardiac evaluation may lead to a variety of responses, including delay or cancellation of surgery until the cardiac problem has been clarified and treated appropriately. This ideally would include direct communication with the surgeon, anaesthesiologist, and other physicians, as well as discussion directly with the patient and, if appropriate, the family. Conclusion: Preoperative cardiac evaluation is very important for all the patients undergoing gynaecologic surgery because cardiac related perioperative complications are well-known in general practice.