FIGURE.
Cardiac evaluation and care algorithm for patients undergoing noncardiac surgery, based on active cardiac conditions, known cardiovascular disease, and cardiac risk factors in patients aged 50 years or older. ACC = American College of Cardiology; AHA = American Heart Association; HR = heart rate; LOE = level of evidence; MET = metabolic equivalent.
* See Table 2 for active cardiac conditions and Table 3 for cardiac risk levels of noncardiac surgical procedures.
† See Table 4 for estimated MET levels.
‡ See Table 5 for clinical risk factors, which include ischemic heart disease, compensated previous heart failure, cerebrovascular disease, diabetes mellitus, and renal insufficiency.
§ See Table 6 for recommendations for using perioperative β-blockade with patients in whom this therapy has been shown to reduce cardiac morbidity/mortality.
From J Am Coll Cardiol,3 with permission from Elsevier.