Abstract
Careful management of the patients undergoing elective surgery is challenging in the perioperative setting because of complex conditions that may or may not be related to the pending surgery. Not only must of the consulting physician like internist, anesthesiologist, cardiologist and family physician take into consideration any complications inherent to the surgical procedure, but they must also consider all related comorbidities plus any previous chronic conditions. In this regard, a careful systematic approach should be undertaken, which consists of: perioperative risk stratification, medical therapy optimization and reduction of complications. Risk stratification is determined by the patient's inherent perioperative cardiac risk factors, whereas medical optimization and diminished complications are actively determined during the hospital course.Our review describes the 2014 American College of Cardiology/American Heart Association (ACC/AHA) Guidelines, and 2014 European Society of Cardiology/European Society of Anaesthesiology (ESC/ESA) guidelines focusing on 5-Step algorithmic approach to managing this clinical problem, particularly for the patient with known or suspected coronary heart disease.
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