Table 4. Active Cardiac Conditions That Are Contraindication for Non-cardiac Surgery.

Conditions	Examples
Unstable coronary syndromes	Unstable or severe angina (CCS class III or IV)*
	Recent myocardial infarction†
Decompensated heart failure (NYHA functional class IV; worsening or new-onset heart failure)
Significant arrhythmias	High-grade atrioventricular block
	Mobitz II atrioventricular block
	Third-degree atrioventricular heart block
	Supraventricular arrhythmias (including atrial fibrillation) with uncontrolled ventricular rate (HR > 100 beats/min at rest)
	Symptomatic bradycardia
	Newly recognized ventricular tachycardia
Severe valvular disease	Severe aortic stenosis (mean pressure gradient > 40 mmHg, aortic valve area < 1.0 cm2, or symptomatic)
	Symptomatic mitral stenosis (progressive dyspnea on exertion, exertional presyncope, or heart failure)

(Adapted from Douglas et al. J Am Soc Echocardiogr 2011;24:229-67). CCS: Canadian Cardiovascular Society, NYHA: New York Heart Association, HR: heart rate. *May include “stable” angina in patients who are unusually sedentary. ^†The American College of Cardiology National Database Library defines recent myocardial infarction as > 7 days but ≤ 1 month (within 30 days).